Anxiety Open Thread

Okay, Awkwardeers, it’s time. I’ve promised to host this thread for a long time, but was waiting for 1) time when I personally had time and mental energy to read & moderate it and 2) for some kind of initial framing device or question.

Thanks to a nice person on Twitter, I definitely have #2. This person would love to attend an Awkward Meetup, but their anxiety is too severe and is holding them back.

Like the Asperger’s thread we had a while back, this should primarily be a thread BY people with anxiety disorders FOR people with anxiety disorders. Hopefully we’ll end up with stories, tools & workarounds, resources, a place to vent and feel less alone. If you blog about living with anxiety or make creative work about anxiety somewhere else, feel free to self-promote that here – just include a brief description of what’s at the link so I don’t accidentally banish you to spamland.

So one of the things that I’ve been thinking about a lot recent with regards to anxiety specifically is the way anxiety makes it impossible to tell how bS things really are.

At my worst, I had the following things to do:

– I had to contact a credit card where I had a lot of missed payments and schedule a payment plan. This paralyzed me with fear.
– I had to go to the library and explain that I had a squillion overdue books and that I wanted to pay my fines. This paralyzed me with fear.
– I had to talk to my workplace about changing my direct deposit from one bank to another. This paralyzed me with fear.
– I had to get a blouse dry cleaned to remove a spaghetti stain. This paralyzed me with fear.
– I had to go to the store and buy a quart of milk, some eggs, some ground beef, a loaf of bread, and some apples. This paralyzed me with fear.

You can see the problem. The first thing is the kind of thing that is, I assume, pretty paralyzing (or, at least, unpleasant) for ANYONE. The last thing is something that most people can do without even thinking of it. But my anxiety was so high that everything–everything! including buying a dozen eggs!–was BATTLESTATIONS BATTLESTATIONS ALL HANDS ON DECK territory.

One of the things that I realized is that good friends tend to feel that Good Friend Behavior is to validate your feelings. You’re scared? Then you probably have a reason to be scared! You’re angry? Then probably someone did something angry-making! This is legit good friend behavior most of the time… but it falls down when it runs into the Wonderful World of Anxiety. I did need people to tell me that I was not a bad person for being terrified of the dry cleaner or the grocery store, I grant you. I needed people to tell me that it was okay to be anxious. But I didn’t need people validating that feeling, because “yes, the grocery store is terrifying!” is a) not actually, you know, really true in the grand scheme of things, and b) not helpful for someone who wants to be able to function normally.

It would be fair to say that I needed understanding. I didn’t need validation, though. I didn’t need anyone encouraging my crazy feeling that the grocery store was deeply dangerous.

And that, to me, is the terrible double-edged sword of anxiety. In order to feel understood, you need to feel like people get and sympathize with your irrational fears of, say, ordering a capuccino, or dropping off your blouse at the dry cleaners, or paying your electric bill. What you don’t need is someone reinforcing that fear. You need, “I’m sorry it’s so hard for you. Can I walk with you to the dry cleaner?” You don’t need, “Yeah, man, dry cleaners are AWFUL. You’re totally right to be paralyzed by fear!” The former is generous and kind. The latter is actually making you worse.

I’m sure I’ll have more to say as the thread progresses–this is something that has been close to me my entire life. But that’s the first big one, for me: recognizing that the distorted thinking of anxiety is SIMULTANEOUSLY both real and unreal. It’s real because you really, truly do feel that you might die if you go to the dry cleaner’s. It’s unreal because that thinking is illogical, and, with patience and effort and kindness, you can get to where you can go to the dry cleaner’s without dying–and, eventually, without even flinching.

This is kind of like the ‘I know how you feel’ problem. They think they’re being encouraging and reassuring, but actually it’s just really annoying because we know it’s not true, even if they think it is.

Badger Rose said: July 8, 20136:46 pm

Or worse, wrt anxiety: we think it *is* true–see! going to the dry cleaners is ACTUALLY IMPOSSIBLE! Now I have an excuse for hiding in my closet for a month.

One of my personal self-care rules is “be kind to yourself, but don’t feed the anxiety.” That means that I can tell myself, “Yes, it sucks ass that I have to go to the dry cleaner’s today. I don’t want to. Once I’ve done it, I get to come home and watch the Mary Tyler Moore show and eat ice cream. But actually going is entirely doable, so I’m going to do it.”

WKP said: July 8, 20136:50 pm

Good point. One of my reassurance techniques is to look for other people who are less anxious about the situation than I am. So if I talk to someone and they say they feel as anxious as I do, I suddenly believe my worry is justified and it makes everything even worse.

mooocow said: July 9, 20132:44 pm

I do that, too. I have a thing about food where, as soon as something has been in the fridge for a few days without me eating some of it, I’m scared it might be off (and indescribable bad things will happen if I taste them, like – …? I’ve never really figured out what I’m actually afraid of, there). I will even smell/see/taste the “offness” of perfectly fine food.

The best thing then is to have my SO or some other non-angsty person smell/look/try it and declare it just fine – and lo and behold! I can eat it, too!

Oro said: July 9, 20137:08 pm

@moocow Jesus I thought I was the only one who did that with food in the fridge. Thank goodness for SO’s who will eat pretty much anything. (and are patient enough not to roll their eyes when I eye the juice in the fridge and consider throwing it out).

@Caitlin I do the same thing! For me it’s because that would be WASTEFUL. Obviously. (sigh)

mooocow said: July 10, 20138:59 am

@Caitlin: I do exactly the same thing (If there is no SO or other non-angsty person around to give me the reality check). I think it’s because, as long as it’s not definitely bad, my bad conscience about not wasting food is too strong and I can still be in denial (“Oh, I’ll just eat that… erm… tomorrow/next week/…”)

sera said: July 13, 201312:38 am

i got a lot of this when i started telling my friends i have anxiety, and it only made things worse for me because how did they manage to get through and why am i the only one having trouble?

JC (Sara) said: July 8, 20139:13 pm

This is really interesting and useful information for friends of people with anxiety I think. I have a friend with a (sometimes) pretty severe mental illness that can distort their thinking. They have built up a network of people around them they use to reality check their thinking and reactions to situations. It requires a high level of trust and honesty but it works for them. I really admire them for being able to do that.

Agreed. My husband has anxiety issues that can be really frustrating for the people around him. The OP – and really, this whole thread – put this in a way that I think will help people who don’t have anxiety but know those who do to be more supportive or at least understanding. I need to make “recogniz[e] that the distorted thinking of anxiety is SIMULTANEOUSLY both real and unreal” my mantra.

My mom worries about the same things I do, so when I talk to her and she validates my irrational fears my brain doubles down, nothing keeps my anxiety in check. Like I registered to take a famously easy exam, and when I told her about it she told me, among other things, to make sure I don’t study for an old version of the test and that she will buy me a study guide if I need it but I have to let her know right away or the coupon she wants to use will expire.

J. Preposterice said: July 8, 201310:44 pm

oh my god, my mother, my goddamn also-has-anxiety mother. the way she feeds my yammering, worked-up, panicky brain is unreal and unholy. Four years ago, she didn’t like me letting my dog near my baby, because “what if something happens? what if Bella bites him and mars your perfect baby?”

I didn’t let Bella in the same room as the baby for weeks afterwards. This was no mean feat in our old house, which was TINY. Rationally, I knew a) not to leave dogs ALONE with babies, but a supervised situation with a gentle dog is not a meaningful risk b) Bella, in particular, is dangerous only to houseflies, unattended sandwiches, and the cat’s dignity (it is hard to be dignified while being humped by a dog, just sayin’). But I couldn’t shake it and it gave me horrible nightmares and the shakes and the whole deal.

That was about when I decided that I was going to make with the boundaries, because I really didn’t need any repeats of that. My mom? Not so great with boundaries; she gets caught up in her anxiety and starts talking over my “I really don’t want to discuss that” and my “Mom, this topic is very upsetting, let’s do something else.” So I’ve started enforcing it with screaming. She ignores a boundary (like “let’s talk to J Preposterice about infanticide when she’s 8.5 mos pregnant and NOT STOP when asked REPEATEDLY”), and I just scream, wordlessly, at the top of my lungs, and hang up on her and refuse to speak to her again until she apologizes.

I figure she deserves it, because my son’s 4 now and any time either of the Preposterice Hypotenuse children get up to anything even mildly risky, my brain starts yammering, in my mother’s voice “mar your perfect baby mar your perfect baby mar your perfect baby” and I have to bite my tongue and dig my fingernails into my palms. THANKS, MOM.

Pterinochilus murinus said: July 9, 20138:31 am

I love your screaming tactic. That’s a great idea.

“mar your perfect baby” what the actual fuck. The way it’s phrased sounds like she’s more concerned about cosmetic damage than if the kid gets hurt (and it sounds like you’ve already made a better risk assessment about that than she did.)

J. Preposterice said: July 9, 201310:52 am

The screaming was really embarrassing the first time I did it, because I didn’t know I was going to do it. But it worked SO WELL that it is now my go-to. I don’t recommend it, exactly, because it’s…I don’t know, immature-feeling? Childish-seeming? But it turns out it’s really hard for someone to verbally violate your boundaries when they are met with a wall of screaming and phone hang-ups! They can’t get a word in edgewise!

cleverhound said: July 9, 201311:38 am

Oh man, I would hang up the phone on my dad. It took me such a long time to realize that his thinking was abnormal and it was feeding very badly into my anxiety. (Me, to my therapist: “Any time I wonder where my anxiety comes from, I spend a little time talking to either of my parents.”)

For example, my dad got me so worked up about a potential winter storm, I made myself sick. I was already in the darkest part of my anxiety that drove me to seek help, but here I was, barely able to leave the house, and this storm was coming, and I didn’t have enough food. Or batteries. So the morning of the storm I dragged myself out of the house on the edge of panic (because if I didn’t get supplies, clearly the storm would come and I would be stranded and die or something) the moment the store opened to get batteries and granola bars. I spent so much energy worrying about this storm, because that is what my dad trained me to do, and it was about two snowflakes. I hit my wall. I realized this was so excessive, and exhausting, and there had to be a way not to do it. Lots of therapy later, I have found it.

I got a new job recently, and told my dad. He skipped the “excited for you” part and went for some kind of long thing about safety, and was I going to be alone in the park, and were they remote and on and on. After redirecting him many times, I finally ended the conversation. Later I realized he is actually worried about someone literally leaping out of the bushes and attacking me. Like, this is a genuine fear of his. And that is freaking ridiculous. That really helped me say, his fears belong to him, not me. And they can be absurd, and I still don’t have to listen to them.

I’ve got enough of my own anxiety bullshit to deal with, I really don’t need someone else’s. And realizing that his fears were not normal was a really big day for me. Like, other kids could just go to the beach, any time. You were at the beach, go to the beach. Not you can only go to the beach for 30 minutes at a time between the hours of 9 and 10am, otherwise you will clearly get heatstroke and die. This year I finally figured out that other people just went to the beach. Whenever. And you drink water and wear sunscreen and play in the water.

Sometimes it feels like deprogramming, like I’ve been brainwashed and I’m slowly realizing it and stepping back. I feel bad for him that he has so much anxiety and is not willing to recognize it and get help, but that doesn’t mean I need to take it on.

J. Preposterice said: July 9, 20134:33 pm

I feel you! And…hanging up. So useful.

Sara said: July 22, 20139:48 pm

I also work in parks. I have found it helps other people calm down about my walking around outside after dark when I say, “I’m not scared of the dark. I’m scared of people. But most people… are afraid of the dark .” Not saying it will work on an anxiety overachiever like your dad, but it has defused many people’s worries when they were aimed at me.

My mother is extremely anxious about everything on planet Earth. When I went to college, she told me, in all seriousness, never to leave the dorm after dark, even for dinner. I lived about a hundred feet from Dining Services, down a very well-lit sidewalk that even had a campus emergency phone smack in the middle of it, in a place where dark, during the winter, was about 4:30p. She knew that, because she helped me move in. It occurred to me at that point that she might be a bit bonkers.

In the years since, I’ve described her behavior to a couple of people who asked me, as politely as possible, if I thought she might be paranoid schizophrenic. (No, but mostly because I’m unaware of her having hallucinations, and her affect is fine, although a lot of her reactions are weirdly-not-adult.) I’ve no idea about your mother(s), but if anyone comments on her behavior being bizarre, you might ask them what prompted them to say that. It could be enlightening.

Mahvelous said: July 18, 201310:59 am

Kudos to you for recognizing this pattern! I’ve also had this issue with my mother (her anxieties feed off of mine). What I do now, instead of screaming (which does work BTW), is to say, calmly, “Mom, you’re not listening. I don’t want to talk about this. If you keep talking about this I am going to hang up/leave the room/walk away.” People in my family just tend to escalate our volume to be heard over each other, so sometimes I say it LOUDLY and (as) calmly (as I can), but it seems to work OK. I also try to remind her, when she’s not currently in an anxiety spiral, that I’m really not responsible for her anxieties; joking about it (“I have enough of my own, so please keep yours to yourself”) seems to work, but we have an otherwise good relationship.

Kate said: July 9, 20135:42 am

Aaargh, mothers. One’s own one is much harder to deal with than other people’s ones (at least it feels that way to me).

I don’t have an actual anxiety disorder, as far as I know, but I have extreme physical risk aversion [*] and am very heavily towards the ‘flight’ end of the fight/flight reaction to fear.

Also ever since my cancer diagnosis 10 years ago I get strong unwanted visualisations of ways I could die (I could step under that train, I could fall off my bike, I could slip with the knife when I’m chopping vegetables – if I’m tired or stressed or down, this type of image comes at me all the time. Not so much on good days, or I can shrug it off more.)

I am trying to learn to kayak, and was telling Mum that it was hard to get over the nerves. So she starts going into graphic detail about being trapped under rocks, etc. I ask her to stop and change the subject, and she switches onto how actually driving a car is much more dangerous and people underestimate the risks of road accidents, and…

Luckily the second time I asked her to stop, she did.

It’s clear I got the fear reactions from her (I have seen her have the same freeze/cry reactions I get), and she may even have it harder than me. But she’s also very emotionally demanding and drama-queeny, and everything is always about her.

And she’s a trained and qualified counsellor, and lots of people think she’s wonderfully empathetic. AAARGH.

[*] I am just realising how much worse my physical risk aversion is than other people’s. I was on a beginner/improver kayak weekend just now, where I’d been learning kayaking for much longer than some people. So on the first day we did basic river skills, and mine are fairly good for someone at my level. I was in the middle/top part of the group for technical skills. Some people had not encountered the technical skills at all before, and some couldn’t do them at all.

I was absolutely definitely not going to do it – not mentally ready for it – but every single other person on the group did. Of course half of them fell in, but they didn’t mind. I would have been paralysed with fear and shock.

I do not understand how someone can be absolutely new to the technical skills the first day, but happy to try something like that the second day. I don’t know what’s wrong with me, that I’m the only person who won’t.

Rachel said: July 14, 20133:22 am

WRT the kayaking: You’re only seeing a self-selecting subset of people tackling that course. Think of three groups of people: 1) will never go kayaking as not interested/too scared; 2) interested, a bit nervous; 3) WHEEE!!! Kayaking! You will only see groups 2 and 3 at the kayak place, and you may be the only person in group 2, but that doesn’t mean you’re the only person too risk-averse not to tackle the course; everyone in group 1 is also too risk-averse/uninterested. Yay you for doing an activity and setting boundaries that make you feel comfortable.

tired of something said: July 8, 20139:42 pm

I think this is also dependant on the particular anxiety issue. I have PTSD, and the things I am most anxious about are indeed real safety issues. Being around a former partner who is violent, sleeping in unfamiliar spaces with unfamiliar people, etc. are experiences that have consistently proven to be extremely unsafe for me, and also feel unsafe. They trigger PTSD reactions AND are feelings about safety that I have to trust. I have had friends (who have never experienced trauma) try to reality check this and it just minimizes my very real experiences, which I experience as dismissive. Beyond that, part of my work has been research on violence so I actually know what statistically puts me at risk and what does not and it is immensely frustrating for me to have both my lived experience and my research knowledge dismissed. For me what helps from friends is the reminder that I am actually the best judge of what I need in a given situation, a reminder that the resulting PTSD reactions are managable, and there are safe spaces available (and preferably for friends to be willing to create safe spaces).

Badger Rose said: July 8, 201310:09 pm

I think it’s dependent not just on the anxiety issue but also on the personality of the person, because I also have PTSD, and have fears based in real-life safety issues. It’s just that what I need to deal with them is different than what you need.

Perhaps the best general answer is “don’t assume you know what your friend needs.” For me, it’s ‘don’t feed the fear, please.’ For you, it might be something like ‘trust that I know what I’m doing, please.’

tired of something said: July 8, 201310:30 pm

Yeah, for sure. I think that is the trouble, that people often assume what someone else needs – in the case of my friends, a lot of them assume it is best for them to challenge the safety issues, and I find it draining to (often repeatedly) have to tell them that is not helpful to me. I would find it much easier if “don’t assume you know what your friend needs – check in” was the go-to response!

Badger Rose said: July 8, 201310:33 pm

Yeah, that makes sense–I’ve had a lot of situations that go the opposite way, with friends who say, “Oh yeah, making phone calls is really terrifying, and banks are the worst! They always keep you on hold forever and they never follow through anyway! And wow, the tellers are so rude! And then you get some bullshit charge on top of it!” Which of course makes me, ah, rather less than inclined to actually make the horrible phone call–not helpful if it’s a call I have to make.

Yes, this. Your original comment definitely made me think about this and how to make sure I’m not just assuming what people need. It did make me think that my experience has been a little different (though now with your example below I see more what you mean by the confirmation of your fears and how it could feed the fear) and something I’ve found really helpful in dealing with my (undiagnosed) anxiety has been talking to friends who I know have similar experiences and having them validate that, yes, sometimes going to the grocery store, talking to your roommate etc. feels really scary. We’ve developed a kind of interaction where we validate each other’s feelings and try to strategize about how to do the scary thing. Sometimes this means saying “Is there a way you can do it tomorrow? It sounds like you are too overwhelmed now.” Then we congratulate each other on doing the thing, which, when sometimes it’s literally “leaving the house today”, is really nice to have someone who understands how hard that was and what a big accomplishment it was. I think it’s really helpful for me because I tend to go into a shame spiral about it, i.e. “Why can’t I do this? I should be able to do this thing and five other things right now!” that ends up sucking up my energy and ultimately I end up doing nothing and feeling horrible about it. To have someone intervene and say “If you can just do one thing right now, it is a huge accomplishment and I’m proud of you and if you can’t, that’s okay, too” somehow lifts a huge burden off my shoulders and makes me feel less isolated and incompetent. It also helps that my friends are awesome and I’m like “Well, if they’re scared of this, too, I guess there isn’t anything fatally wrong with me for being scared.”

I’m so sorry if I’m overstepping my boundaries here, but maybe what your friends are trying to do is take your anxiety down a level? I know for me, trying to calm myself down I tell myself “Everything is going to be OK” even if I have NO IDEA if things are actually going to be OK, because it gets me level… dismissing your experiences is not cool, they just may not know how to react otherwise… sorry if I’m coming off as dismissive.

That Girl said: July 8, 20139:47 pm

Before I even started to read the comments I was going to post about my solution to the grocery store. It took me a few years, but I would start out putting non-perishables in my cart, then go sit outside for a few hours, then go back in and pay. Perishables a few at a time a different time. For years. Building up my tolerance, coaxing myself to be able to expand my tolerance until now I can do a full shooping cart, pay and leave without taking a break.
For me, it was kind of the same as Captain Awkward’s depression fixing advice. One little step at a time, backsliding treated gently.

Unrepentantfangirl said: July 9, 20135:19 am

I’ve found my best solution the the grocery store problem is drugs and music. I’m on a perscription for my anxiety so that mostly stops the panic attacks. And if I have to shop alone I just crank some music in my headphones the whole time or listen to an audiobook. Radio comedy is great because it takes up enough of my brain that I only have enough space left over to remember I’m out of ready noodles.

When I decided I wanted to go to the gym I used a similar tactic. I took of my glasses so people were fuzzy, put in headphones and took meds if it was safe for me to do so (they lower my blood pressure, so I have to be careful). I couldn’t really see or hear anyone, so they ceased to exist!

Unrepentantfangirl said: July 10, 201311:40 am

The only problem with that when I do that I get the beautiful jerk brain guilt tripping me bout closing myself off from people and being unfriendly and how I’ve not arraigned to see a friend and on and on. Yay. Anxiety!

Muddie Mae said: July 11, 20132:33 pm

That is so interesting about the glasses – I have exactly the opposite feeling about my glasses. They just broke yesterday (alas!) and I’ve noticed my anxiety spiking since then because I don’t see well enough to recognize people or identify facial expressions from farther than 6 feet.

Muddie Mae – yeah, I have no idea why it works for me because I have a lot of anxiety around not being able to see ‘threats’ coming (I put threats in scare quotes because seriously, Alice, a waiter at a restaurant – NOT A THREAT) but it occasionally works! Logic and my jerkbrain are not very well aquainted.

I hope your glasses get fixed soon, that sucks.

twomoogles said: July 8, 20139:58 pm

Very well said! I have a pretty good core group of people who tell me helpfully when my anxiety brain is working in overdrive (I need this and have asked for it.)–partner, best friend etc. I also sometimes have the opposite problem–someone who knows some of my issues will tell me something isn’t a big deal when it demonstrably IS a big deal! For example using your list, they’d tell me having all the missed payments on a credit card would all work itself out, everything would be fine!

It’s like when applying for something with 100+ applicants and someone just keeps saying ‘you’ll absolutely get it, no chance you wont’ when actually…it’s a pretty big chance, regardless of how well qualified.

I have a relatively easy time telling when something is a big deal practically speaking, but it took awhile to get there. Where I still have problems is emotional stuff. I have a constant low-level worry in the back of my brain that my friends all hate me, my boyfriend’s about to dump me, and I’m about to get fired for my job. This can sometimes make it very very hard to tell when there’s an actual problem with a friend, job etc.

I love when someone is clear with me when they are upset with me. It makes it so much easier to think ‘well, if there was a problem, they’d say something’. As opposed to thinking ‘nope, everything’s fine, it’s just my anxiety working in overload’ and then finding out, no, there actually was a problem the whole time. Which makes the cycle worse the next time…

OMGERD yes about people letting you know when they are upset with you! 95% of my anxiety would probably be put to rest if most of the people I interacted with on a daily basis I could trust to operate by this principle (and I mean let me know by saying “I am upset with you + [thing they need from me to help them be less upset – my absence, an apology, etc.]” not by yelling at me). Definitely lots of childhood trauma feeding into this aspect of my anxiety!

keelyellenmarie said: July 9, 20133:53 am

“I love when someone is clear with me when they are upset with me. It makes it so much easier to think ‘well, if there was a problem, they’d say something’. As opposed to thinking ‘nope, everything’s fine, it’s just my anxiety working in overload’ and then finding out, no, there actually was a problem the whole time. Which makes the cycle worse the next time…”

This, to the millionth degree.

Most of the time, when someone who is close to me tells me in clear, specific terms that they are upset at me and why, I respond by hugging and/or thanking them, and then proceed to work it out calmly. What I can’t handle is someone snapping and getting very angry about a small issue that apparently been fucking up for days or weeks without anyone mentioning it–in those situations, I tend to get overly emotional, or completely freeze in panic.

The WORST thing is that when people fuck this up when they’re trying to be helpful. Say, when I’ve been sorta depressed and down on myself for awhile, and my job search is going like shit, and my girlfriend decides not to tell me about something she needs or that is bothering her because she is afraid she’ll make things worse. My girlfriend doesn’t lose it or get mean, but she eventually I figure out something is up and ask her questions until she comes out and says “well yea, maybe you could stop doing that one thing, but I didn’t want to make a big deal out of it…”. Cause then my brain is like “see! See! all the anxiety was RIGHT! you should be constantly worried that you’re making her secretly hate you!”

Just Plain Neddy said: July 9, 20136:21 am

My experience has been on the other side of this situation and it’s not easy there either, particularly if you’re also anxious. Because you may be anxious about communicating with X about [minor annoyance] in case X gets upset. Particularly if X is worried about criticism or has a jerkbrain that sends in the nukes when the slightest criticism is found anywhere. You find yourself asking: am I really annoyed with X, or am I hungry, or tired, or what? Maybe I’m just grumpy – I’ll wait and see if it still annoys me tomorrow. Because we’ve all been in a situation when someone is annoying the hell out of us, and then there is coffee, or sleep, or a snack, and everything is suddenly much better. So you wait and see if that’s the case. But then, having put it off, you have another problem, because you know that X will now be extra upset that you didn’t mention it before. It gets more and more nerve-wracking the longer you leave it, and you really just want it to go away.

I had an ex who deflected every criticism by saying “why didn’t you mention this before?” which sounds reasonable but actually it was a pretty good way of throwing everything back at me – it was a good way to get angry at me rather than deal with what I had said. And it was every.single.time. It didn’t actually matter when I brought the issue up – I was at fault for not mentioning it sooner.

I’m not saying that you do this and I do see where you’re coming from. It’s just that from the other person’s perspective, it may not be as simple as “just tell him/her”. And if they do wait to tell you, please resist the urge to complain that they didn’t say anything earlier, because that actually makes it harder, not easier, to speak out next time. If I put this in terms of basic Pavlovian conditioning: if your dog runs around and misbehaves and drives you crazy, and you can’t get him to come back to you, it’s really important that when he does come back you praise him. What you want to do is yell at him for misbehaving in the first place, but then the message that he gets is that you called him, he came to you and got yelled at. I know this is a little basic when we’re talking about humans, but it’s easy to make the connection that “when I do finally say what’s on my mind we’re going to have a massive argument about it.”

It sucks when someone criticises you and the jerkbrain takes this opportunity to nuke. I know that situation well. However, the person criticising you can’t be held responsible for the mushroom clouds at that point.

YES x 1,000 about the “why didn’t you mention this before?” as a deflection. That frustrates me so much.

Brittany said: July 9, 20138:38 pm

“I had an ex who deflected every criticism by saying “why didn’t you mention this before?” which sounds reasonable but actually it was a pretty good way of throwing everything back at me…”

This is my mother. And it is THE WORST. It is among the major reasons I stopped telling her anything consequential years ago and basically don’t talk to her at all anymore. (The other major reason being that the answer was usually “Because I knew you would flip pout and yell at me and make it all my fault but all about you and not actually discuss my concern.”)

As an anxiety-person with this upbringing, my strategy is three-fold when I start obsessing whether someone is upset at me:
1. Treat people as if they are grown-ups who can communicate their own feelings. If I highly suspect they are upset at me, ask–once. If they tell me no, trust them. (It doesn’t matter if I think they are lying–if you tell me to your face you’re not mad, I am going to act like you aren’t mad.) Don’t be a jerk, but in general don’t cater to potential-feelings-no-one-talks-about, but only to real feelings that are communicated.
2. Create safe spaces. Mostly, I find people hide their feelings when they feel unsafe or like they will be punished for having them. This can be a result of how you’ve reacted in the past (see the dog example above) or be the result of THEIR past with literally nothing to do with you. But actually create safe spaces for people to share their feelings. That means when someone tells me something, the reaction is : Thanks for telling me. I appreciate it. I know it’s hard, but if we don’t talk about it, we can’t fix it. (Note: This is the reaction /even if they thing they are saying upsets me, is unfair, or I think it’s untrue./ Talking about my feelings are part of working it out but NOT appropriate as an initial reaction. Also, note that this does not necessarily include an immediate apology, though it can if it’s obvious to be that I’ve fucked up. But I’m an over-apologizer (I AM SORRY I AM A PERSON WITH NEEDS AND FEELINGS IT IS THE WORST), and I’m trying hard to cut back.)
3. Cut out shitty people from my life. Yes, some people DO hide their feelings and then explode on you about something that would have been an issue 2 weeks ago but now is. Or do secretly hate you for something you did 3 years ago. Or expect you to notice every time you get a bit miffed. Fuck those people. They have no place in my life any more. (I am very clear about this to friends: If there is a problem, you (eventually, I know sometimes it’s hard in the moment) need to tell me about it. I will not chase down your moods or jump whenever I see a frown, so don’t expect me to.)

Bluegirl said: July 9, 20138:42 pm

Re: “Why didn’t you mention it before?” I had an ex who did a similar thing. It wasn’t the same response every time, but any time I tried to bring up a problem – or even just tell her news she didn’t want to hear – instead of actually engaging with the thing I’d said, she’d turn it back on me by complaining about the way I told her. If I waited for a good time to tell her things, I was hiding things from her; if I brought things up right away I was ruining her day; if I said things by email I was a coward; if I told her bad things face to face I was ambushing her… and the result was that the slightest confrontation ended with me being bad guy who did her wrong and had to ask for forgiveness, and the problems I brought up in the first place never got addressed.

keelyellenmarie said: July 9, 201310:03 pm

Thanks for this. I do get that it is very hard to be on the other side of this too, and I try to stay aware of that. And like I said, when someone does address an issue with me in a straightforward way, even if it has been awhile that they’ve been holding back, I’m usually grateful that they’re discussing things with me rather than yelling.

I don’t think I use the “but why didn’t you say it sooner?” as a deflection, but I will be sure to watch for that in the future.

azora said: August 5, 201312:01 pm

Brittany on 7/9/13 – thank you. From the scared and insecure and hidden corner of my heart: thank you. I really need coping techniques right now, and I hope this will help.

cleverhound said: July 9, 201311:41 am

Yeah, one time I figured that weird noise my car was making couldn’t possibly be anything serious, it was just the tires adjusting after being rotated. It was my anxiety, that’s all. Blowing something out of proportion.

Yeah, no. They didn’t tighten the lug nuts on one wheel, and the damn tire almost fell off my car while I was driving.

It was the worst anxiety experience ever, because my damn anxiety was right.

VA said: July 9, 20133:08 pm

“I have a constant low-level worry in the back of my brain that my friends all hate me, my boyfriend’s about to dump me, and I’m about to get fired for my job.”

The (fortunately very minor) panic attacks are new, but that low-level narrative has been in my brain, all the time, for years. I truly didn’t know until this moment that it was a part of the anxiety, and not just How Things Are.

Cosign. I know the dangers of internet diagnoses, but I am starting to wonder if I need to find a professional to talk to about this. “But what if my friends don’t REALLY like me and they’re all wishing I would just go away already?” has been with me since childhood and I always kinda thought it was normal to be on your toes about being a good (fun, interesting, exciting, etc) friend. But I am pretty sure I am a good (fun, interesting, etc.) person so – especially after finding CA and learning more about how different minds work – I’m starting to rethink whether this is something I can or want to live with forever.

Mahvelous said: July 18, 201311:10 am

Hello there! Speaking as someone with an anxiety diagnosis, and someone going into the counseling field: Whether or not you have a diagnosis, a (good!) therapist/counselor can help you work on that self-talk. I’ve discovered that I need to go in for “tune-ups” for time to time, and it has been really helpful to diminish (though not erase) icky thoughts about myself and my relationships. Please do yourself the favor of finding a therapist you click with who can give you the tools you need to silence those thoughts from time to time. Speaking from experience, I highly recommend that you go with your gut when talking to professionals; it’s important that you find a therapist with whom you can relate comfortably. Just as a good medical doctor should listen well (and follow your lead as needed), be empathic and kind, and show caring and concern for your well-being, a good therapist does the same. Best of luck to you; you deserve it🙂

Lindsay said: July 9, 20137:19 pm

“I have a constant low-level worry in the back of my brain that my friends all hate me, my boyfriend’s about to dump me, and I’m about to get fired for my job. This can sometimes make it very very hard to tell when there’s an actual problem with a friend, job etc.”

Ugh, THIS. It’s not necessarily 100% present for me, but for instance, when I really do screw up, I have a hard time believing my friends when they say they forgive me. Even though I KNOW they love me and aren’t jerking me around. Jerkbrain says “you’re a piece of shit and you should feel bad about it, it doesn’t matter if they say they forgive you, you must torture yourself for several days because they probably didn’t mean it.”

popesuburban said: July 10, 20131:10 am

That’s me too! And the fun thing is, I’ve run into some people who were colossally judgmental assholes, who also made a point to keep quiet about it for whatever reasons– at least, until they laid it all out that I was a terrible person (who bought them nice Christmas presents, who cleaned up after dinner, who tried to magically be a loud, talkative person though it physically hurt) and they were long-suffering saints (who never really acknowledged me as a person, and who would forgive blatant horrible rudeness in others). Which, hey, doesn’t really *matter* much because I don’t like people who do that, but which also constantly leaves me wondering if New Person is like that, and if their judgment is going to cost me a job or an apartment or friends. I’m always playing a shell game with new people because I’ve met so many other folks who turned out to be, objectively (corroborated by people without anxiety), assholes. Like, shit, it’s happened before, it’s happened before when I was worrying about it, why is it magically impossible now?

Oh, we DEFINITELY had the same housemates. And they have done me a ton of damage. How do you get past that thing of a year of gaslighting and reinforcing of negative thought patterns?! HOW?!

lilaengelrocket said: July 11, 20134:55 pm

we must all have had the same friends! trying to get over those people and the damage they did has been the biggest roadblock in my attempts to live a normal life in recent years. i am unable to make new friends because i just don’t trust people any more. not having friends makes everything a lot more difficult. being lonely just exacerbates all my negative thinking.

twomoogles said: July 12, 20131:30 am

On this topic–I will *also* get really really anxious that *I* am being the horrible bad friend who is gaslighting/manipulating/bullying people, without even realizing I’m doing it. I have no real evidence that I am except for the fact that sometimes people will tell stories of feeling their friends were doing such, and me not quite getting what the issue is. or of a real life friend ranting about x person being awful and me thinking ‘but..I see their point of view…’

I am still trying to figure out if I think some people are just terrible manipulative abusers who know exactly what they are doing, or if they are actually just oblivous and bad for me. And if it matters. But does matter to my anxious-brain! Because if it’s the second one, then I could be that person! The person someone writes about on a blog and says caused damage and all the other posters go ‘yes that was awful’ and…thought spiral!

RMorrison said: July 22, 20138:12 pm

OH, yes, this.

Especially when it involves dating someone. I’m a basketcase with everyone, and while I am way worse with assholes, I’ll get freaked out by completely decent guys too. Which leads to a lot of awkward moments of people suggesting I should “go with my gut” and trying to figure out what MUST be wrong with the guy I’m complaining/worrying about, instead of anyone steering me away from the deep end of the emotional pool

Invert Sugar said: July 8, 20136:02 pm

I know that medicine isn’t the answer for everyone, but for me, my Xanax saves my life. Quite literally, since it’s stopped me from committing suicide several times now. Even just knowing I have it makes me feel better, because I know that if things get THAT BAD, I can use it and it will take the edge off enough that I can get through whatever it is I need to do.

I’m reading Proust’s entire In Search of Lost Time this year, and I find it incredibly comforting that Proust’s narrator was even more anxious than I am.

Badger Rose said: July 8, 20136:09 pm

Oh yeah, medicine is a lifesaver (figurative or literal) for a lot of people. I was on various anxiety meds for years. I am currently not taking any for complicated personal medical reasons, but I am so much looking forward to going back on.

keelyellenmarie said: July 9, 20133:57 am

Yes to the just-having-something helps. I rarely use my ativan but knowing I have it means I don’t have to be anxious about being anxious. Hell, I realized two days ago that I seem to have lost my pill bottle, and now look who’s too late(for the second night in a row) because her stupid anxious brain won’t turn off.

Ellen said: July 9, 20134:13 am

Oh, me too. I find just having it on me is really helpful. I even stuff it into my underwear if I have to wear something without pockets and can’t carry a bag! My knickers, they are chill, yo.

redpen27 said: July 9, 20134:58 am

yes, yes, yes, yes. the only thing that made me able to even understand the idea of my anxiety not necessarily coming FROM something was zoloft. life-changer. like somebody turned off the self-loathing faucet. literally, before that, i thought i had to literally never annoy anyone–never fail to decipher and deliver exactly what they would find most charming–or i would be An Annoying (=Worthless, Hated, Excluded, Creepy) Person. now when i get the sense i am annoying someone, my reaction is something like, “ah, today is my turn to be annoying and talk too much–next time it’ll be the person who’s listening to me.” ZOLOFT!

Pterinochilus murinus said: July 9, 20138:39 am

My psychiatrist and GP are united in their disapproval of ‘drugs of addiction’. So no Xanax for me. No sleeping pills either. They agreed to a low dose antipsychotic as a non-addictive equivalent of an anxiolytic for a while, but I would really like to have something I can take PRN when it gets THAT BAD.

It is worth mentioning here that the closest I have to a substance abuse problem is drinking way too much diet Coke, and they know it. I’m too scared of getting addicted to drink alcohol more than once or twice a year, and I’ve never been drunk in my life. That would require me to lose control.

Brittany said: July 9, 20138:47 pm

Do you really, really like your psychiatrist and GP? And really trust them? Because if you, as the ultimate authority on your body, really feel like you need something and your medical professionals are against it and haven’t given you as satisfactory explanation as to why (it doesn’t seem like they have from what you say?), it might be time to seek a second opinion. I’m not saying hop doctors forever until one gives you free access to a prescription pad, but I would talk to a least one or two other doctors.

I could be way off track and feel free to ignore, but when I am going to a doctor who isn’t meeting my needs (or, really, in any situation not meeting my needs; I’m very self-doubting when it comes to advocating for my needs), sometimes I need someone to remind me that trusting myself and seeking other options are, well, options.

Pterinochilus murinus said: July 10, 20137:14 am

I really, really like them. I have complex health issues, and my GP is good about those. And my psychiatrist is also my talk therapist, and he’s really, really good about that. (Not perfect, but trustworthy, and I don’t say that lightly.)

I hope I’m not telling you stuff you know here, but have you asked about beta-blockers? They aren’t addictive, and if you get physical symptoms they might help. I’m glad your doctors are awesome! Good ones are tough to find

Yes, the right medicine definitely saved my life too. Weirdly enough, the most important thing I got from my miracle drug was during the I’m-stoned-out-of-my-mind side effect phase at the beginning – for literally one minute, the anxiety stopped completely. I’ve never really believed that other people don’t feel anxious all the time, but it turns out that yes, it can be possible to dance or to clean or to make a phone call without any anxiety! When people say they can do these things and don’t feel anxious they mean no anxiety at all, not no anxiety apart from the usual background level.

The perspective can be amazing, just to escape from that sea of anxiety once in a while and experience the feeling of not-anxiety. It’s reminded me that it’s really important to get help for anxiety, whether that’s drugs, therapy or reading every single comment in this thread! You (general you) aren’t just lazy or selfish or making a fuss over nothing, there really is some faulty brain stuff happening and your suffering can be alleviated or even fixed completely.

(I’m definitely on the alleviated side of things, as this comment has taken me over an hour and a half to write and rewrite. The anxiety is still strong with this one!)

Some of them are anxious and are dancing anyway. Some of them usually are but for some reason or substance are not at that moment. I used to dance in crowds when I was drinking, and felt no anxiety. Now I have to be in a headspace of Awesome or Does Not Give A Fuck. Crowds help, certain friends help, and the right music helps. Also it is cultural, and if you grew up dancing it is easier to dance.

I used to dance because in the crowd I was anonymous and nobody watched and I could move, and get lost in myself. It was good. I don’t go to those parties now…

I’m a trained dancer, so I dance pretty much everywhere without anxiety. But the vast majority of people I know DO have anxiety around dancing, especially guys. I’d say dance anyway! The anxious usually wears off.

I take beta-blockers for anxiety, which take away the physical symptoms but leave the mental ones there. I find they’re pretty much a silver bullet for me now, as I can handle the mental stuff but it’s the physical effects I struggle with. Faintness, nausea, severe psychosomatic cramps….none of these are conducive to fun times. It’s also not sedating, which is a big big plus for me!

How did you get someone to give you those? I keep telling doctors that I’m perfectly happy to try Inderol, and they keep giving me Xanax instead. Don’t get me wrong, I’m not complaining about their willingness to hand me things I actually need for the stab-me-in-the-brain panic attacks — I think propranolol wouldn’t work fast enough for that — but I can’t take it for lesser anxiety. Xanax knocks me on my ass even in tiny amounts. I’m taking half the smallest dose they make, and I can’t take them until I hit the point where I’m less useless half-asleep than I am as a ball of shredded nerves. If I have to take one while I’m out in public, the next thing I’m going to be doing is getting on the train home, because I’m pretty much done.

Mahvelous said: July 18, 201311:16 am

Is it possible for you to get a referral to a psychiatrist? They may be more willing to listen than GPs with regards to mental health issues. As to why this keeps coming up…Xanax is currently the number one most prescribed medication in the U.S., and, not to be cynical, many people have worked hard and been well rewarded financially to keep it so. This includes promoting it to medical professionals. IMO (future therapist here), Xanax is not appropriate for use on a regular basis due to its low therapeutic index (kinda risky), and high possibility of tolerance/dependence (physical addiction). Clearly, there’s lots of factors at stake when you talk about switching or changing medication: e.g.,if you are currently taking the Xanax on a regular basis, you should work with your doctor to taper the dose down (it can be dangerous otherwise); but you do deserve to be able to at least have the conversation with a medical professional who is willing to listen to your actual (rather than perceived) needs. Good luck!

I suspect they keep giving me Xanax because I DON’T take these things regularly — I take them PRN as life gets sucky. I might need them three or four days in a row, but then events calm down and I’ll forget I have them for a week or so. Things which are taken chronically, like SSRIs, have so far been much more disruptive than the actual disorder, and are therefore inappropriate. I’d like to try propranolol mainly because it’s something I could take daily without it being particularly risky.

I don’t even know how I’d taper down from what I’ve got. I’m taking 0.125mg at a time, and it knocks me on my ass. I can’t take less because this is quite literally half of the smallest tablets they make. The first doctors to give me alprazolam were GPs in the emergency department, but this particular Rx — which is rolling and has been authorized for what is theoretically five months, but which will probably last me most of a year — is from a physician in the psychiatric urgent care department at a very large local hospital.

I do, in fact, need something like the Xanax in order to be functional. Inderol and its cousins do not work fast enough to inhibit episodic panic. I’m aware of the risks and I have discussed it with/whined about it a lot to, the mental health people who gave it to me in the first place. To be blunt, if the choice is between maybe needing to up the dosage and later come back down sometime in the messy future, and not being a working human being now, I pick the risky drugs. I want something that will work to make sure I don’t need as MUCH of the risky stuff, but I am under no circumstances willing to give up the drugs that actually WORK.

JenniferP said: July 19, 201312:48 pm

Mahvelous & Arabella, This conversation has crossed over into an overstep of the “don’t give medical advice” variety. Not because it’s necessarily incorrect or bad advice, but because we are not clinicians, and, even if you were a clinician, you’re not specifically the clinician for any patient here.

aaq said: July 8, 20136:11 pm

Riiiight so.

I have Generalized Anxiety Disorder that, beyond being, well, general anxiety, manifested itself as several months of daily (sometimes more than daily) panic attacks. FUN.

The way I got my panic attacks kind of under control was getting less depressed. That may not be the most helpful thing ever, but depression and anxiety tend to be comorbid, especially in women. If you aren’t getting treated for your anxiety (because, say, it makes it really difficult to seek treatment, or you can’t afford it), you may have depression and not realize it, so that’s something to consider. I am not a doctor. This also didn’t solve the problem completely. Still having a few a year, but not daily, so progress.

My workaround for a lot of social types of things is to make myself the person in control as much as possible. If everyone is carpooling, I drive myself and don’t take anyone who I wouldn’t be able to foist onto someone else. In the example of meet ups, I would host one (as I get settled in my new city, I plan to) in a place where I felt comfortable, where I was comfortable with the people working there, etc.

That’s about the healthiest suggestion I have. For other things that I have loads of trouble with, I wait for a good day and do everything I can. Or, we can do what I did for apartment hunting: Anxiety over not having a place to live>>>>>anxiety over cold-calling people and meeting with them, so I made the damn calls. That said, I didn’t call a lot of people that I should’ve.

So mostly, I don’t handle my anxiety well, and I’m looking forward to what other people have to say. I let a lot of things go by this past year because of it (like doctoral program applications!!! -_-) and I’d rather… not do that so much.

Yup, the “being the person in control” thing is something I do too, at least when it comes to social situations. Sometimes leaving the house just feels like way too much effort, because everything outside is scary and enormous, so instead I just host dinner parties or movie nights at my place. Or I organise things at places close to me, or at places that make me feel safe. And that way I can control the guest list too.

Of course, it doesn’t work so much for non-social things – I still need to leave the house to buy groceries and go to the dentist and go to work.

Also I often wonder how healthy it is to stay confined in my house all the time, even if I am still getting social time in. Like, where does “ordinary and totally fine introvert stuff” end and “unhealthy anxiety stuff” begin?

Carpe Librum said: July 9, 20135:24 am

OMG, yes!

I haven’t been diagnosed with anxiety, but then I’ve never been to see a therapist, so…

Partner does say I can be too hard on myself, though because my brain believes it is the most unacceptable thing ever for me to make even the tiniest mistake, such as spill a glass of water, since that leads to my brain (and sometimes my ‘out-loud’ voice) saying “This should not have happened! You *knew* the water was there, *you* put it there! You were careful about where you put it because you knew it might get knocked, and not 10 seconds later, what did you do? You fucking idiot! Now the carpet is wet, and you’re going to have to get a towel and soak it up, but it’ll still be damp, so it’ll probably go mouldy! Then you’re going to have to refill the glass, which you’ll probably just knock over again! How could you fuck up something so goddamned simple?” So, maybe not anxiety about doing things, so much as a crushing expectation of being shunned or punished if I cause the slightest inconvenience?

I am more than a bit of an introvert, so big parties always seem to loom as a big energy debt. Therefore I tend to, well-not dread them exactly, but not anticipate fun times.

Since I have one friend of my ‘own’, and pretty much all of my other acquaintances I met thought my partner, most of the guests would be strangers or acquaintances = extra unsettling jerk brain re: “They’re only being polite because you’re here with [partner].” plus the whole small talk thing that I often can’t seem to manage beyond “Sooo… Read any good books lately?”

I thought to myself, “Why don’t people just have *small* gatherings?”

Cue lightbulb moment when I thought to myself, “Hey, partner and I can just invite a couple of people at a time over for dinner, and have those small gatherings ourselves!”

So a couple of months ago I implemented a plan to host dinner once a month.

Awesomenesses so far include:
– My decidedly extroverted partner gets to play up to the guests
– “Dinner” sets a rough time limit of 7ish to 11ish, plus provides brief distractions like checking on the food, offering more to drink etc.
– It is way less stressful for me to be in my own home
– I don’t get stuck awkwardly hovering between two conversations, unsure whether I should join in.
– It gets our bottoms into gear to give the place a bit of a once-over
– By cycling through invitees, we don’t have to worry about working out what to cook most of the time (taking dietary restrictions into account), THEY’RE not going to know we served the same thing at the last dinner (and the dinner before that)!
– Some of those people we have over might decide to invite us over, too.

redpen27 said: July 9, 20135:33 am

” a crushing expectation of being shunned or punished if I cause the slightest inconvenience”

I’m terrible with this too. For me, it’s probably the anxiety, low self-esteem and depression just mingling in my head. I mean, yeah, I *know* intellectually that I don’t have to be perfect at everything and I’m not worthless if I don’t know how to do some things and it’s fine if I talk about my interests around other people, but… that doesn’t mean that I understand how everyone else but me seems to be able to actually live.
Life is so hard and scary…

ReanaZ said: July 10, 20134:04 am

YES. Being in control of social situations reduces anxiety tremendously for me, especially when lots of strangers are involved and I can, like, set boundaries and shit and throw people out of the group when they do jerky things rather than tolerating people who treat others like crap. And many of my friends have anxiety over organising or being in charge of things. So this works quite well for me. i.e. We are not all series of faults (me, bossy and controling, them, meek and “bad at organising”) but rather series of neutral traits that balance each other.

keelyellenmarie said: July 9, 20134:24 am

“several months of daily (sometimes more than daily) panic attacks”

Damn, MONTHS? I can’t imagine. I once had what was essentially a week-long panic attack which was so intense and so unrelenting (Though I had had panic attacks before, I hadn’t had one in awhile so I didn’t have pills at the time), that I was CONVINCED something was physically wrong with me. After three days I was wishing I’d just die already because I was miserable and losing my mind but really couldn’t handle going in to see the doctor and ask for help because they’d just think I’m CRAZY. Somehow I got up the nerve to make an appointment (YAY for my doctor’s online scheduling. If I’d had to make a phone call to make that appointment…) and show up. She actually tested for a bunch of things a) to calm me down and b) because I had had panic attacks before and kept insisting this was ‘different’. Finally concluded that nope, just a panic attack, and sent me home with ativan. I had to take it for four straight days before I could let one dose to wear off without it all starting again. After that I still took it more days than not for awhile, but the panicing-starts-as-soon-as-dose-wears-off did stop, at least.

On one of those let-a-dose-lapse-too-long mornings I woke and immediately started thinking about work/school and within minutes, before I’d even rubbed the sleep out of my eyes, I was panicing. My pills were ACROSS THE GODDAMN ROOM but it took me over an hour to convince myself that I could move to go get them. And stupid, stupid Ativan does not work fast enough… in the hour between taking it and starting to calm down, I decided I was going insane and that I just COULD NOT GO ON LIVING LIKE THIS for the REST OF MY LIFE. Thankfully, I have an amazing extended family member who is the only one who ever talks unashamedly and in polite company about the mental health problems that run in the family, including hers, and I had her number and it occurred to me to call. I think I spit out “I’ve been panicing for days and I have pills now but they aren’t working and I’m going to be broken forever and how have you lived with this for FORTY GODDAMN YEARS?!?” Then that angel of a woman spent the next hour talking to me, until I was mellowing out and at least half convinced that I probably wasn’t losing my mind forever.

…And yea, that all happened in a week. And it was so terrifying and traumatizing, it kind of blows my mind that I still made it through my classes/job for the rest of the quarter (only missed 2 full days of class) after all of that.

After that, if I have panic attacks more than 2 days in a row, I start panicking that I’m going to get “stuck” again. Even though I now have pills to short circuit the process. EEK.

Yeah, that happens. I’ve taken to referring to it as ‘status panickus’. I have a few epileptic friends, and the reason they don’t ever go off their seizure meds is that if they do, and have a grand mal seizure, it’s possible for the brain to get stuck in some sort of feedback loop where seizures beget more seizures forever, until something stops it from the outside, e.g., a paramedic with a hefty dose of sedatives. It’s called ‘status epilepticus’. Rare, but known. I feel it’s a fitting parallel to being in a sustained state of panic for so long that there just isn’t time for me to calm down at all before some other stimulus makes me redline again.

I had to set an explicit limit of two days on those. I can’t eat or sleep when I’m like that, among other things, and while I know two days without either isn’t going to kill me, if it hasn’t stopped by then it may well go on long enough to be dangerous. It doesn’t get to that level now that I have a large bottle of Xanax in the bedside table, but when I was staggering along without health insurance my only option was to be stubborn and ignore the symptoms until I couldn’t, and then hike up to the ER/Urgent Care.

keelyellenmarie said: July 11, 20132:27 am

I actually had a little cousin who almost died from unending seizures… it was terrifying, they had to put him in a medically induced coma to make it stop completely and let his brain recover, and when they brought him out they had him on several different seizure meds all at high doses to prevent a reoccurrence. He was a toddler. The med doses were so high he was like a tiny drunkard for a while until they could wean him off. Scary shit.

Anyhow, unnecessary story. I never made the connection to get there myself, but “status panickus” is a brilliant name. I’m SO sorry you had to go through that without health insurance and having to get treatment at the ER when it got too bad, that sounds AWFUL. Yay for Xanax though!

Actually, the ER staff were the first people I had run into who were in any way helpful. I disconcerted them a lot when I first came in; I look like a complete basket case when I’m like that, obviously, but I’m completely rational and can tell them that I’m having a panic attack, I know it’s not going to kill me, here’s my history of anxiety and depression, etc etc etc. I can only guess that most people are not very coherent during the experience. They asked me if I was suicidal or wanted to check myself in, which I thought were perfectly reasonable questions under the circumstances, but they also listened when I said no to both. I accidentally got a psych nurse who dealt well with strange intellectual people, and he told them that I was sane but under a lot of stress, and that at least in the short-term I’d be fine if they just gave me some kind of sedative so I could eat and sleep again.

I’ve tried everything else I can think of, and Xanax is honestly the only thing I’ve found that doesn’t disrupt my life more than the anxiety does — and I wouldn’t know that unless someone in the ER had talked to me for a few minutes and decided that I probably wasn’t a scammer or an addict. It was much better treatment than I got from anyone at the local low-income clinic.

On of the things that makes being the organizer or host so helpful for me is it means I’m using my anxious habit of scanning the environment to make sure things are safe to scan the environment to make sure things are running smoothly, which is much more productive and satisfying.

the_apricot said: July 9, 20136:06 pm

I’ve long felt that my depression and anxiety are essentially the same problem. It’s as if I’ve been separately diagnosed with coughing *and* sneezing by a doctor who has no word for a cold.

JenniferP said: July 9, 20136:29 pm

As someone who was prescribed Xanax for when the Wellbutrin starts working, yep yep yep yep to this comment.

keelyellenmarie said: July 9, 201310:14 pm

Yea, my depression and anxiety are very intertwined. The only boundary I can draw between the two is way back when the depression first showed up…because the depression became a thing in adolescence, but the anxiety has always been there. But ever since, they’ve been so intertwined… more anxiety = more depression = more anxiety… etc.

Yeah, you’re probably right about that. I have both too, and I’ve been noticing lately that my anxiety seems to be making things worse because I can’t actually get out and actually do things like a normal person, and if I don’t have anything to really fill my life, I get depressed and can’t get out of bed on any day where I don’t have plans. It’s been at the point where going to the grocery store counts as a plan, because it at least gets me out of the house and walking and whatnot.
But, only since I started reading this thread did I start to think about some things. I was diagnosed with depression in fourth grade, but I was only fairly recently diagnosed with social phobia. Both were almost certainly exacerbated by things that happened at the time (lots of bullying, extremely unhelpful and kinda victim-blamey counselor) but I was apparently so shy years before that that my first school thought I was being abused. So, this makes me wonder something. Yes, I did have some suicidal thoughts around that time, but my depression honestly hasn’t been that much of a big deal for me, even though everyone else takes it as this really major thing. Honestly, my bigger problem is the anxiety. So why didn’t anyone ever notice it until now?

Oh yes, this. What I ran into for the longest time was that physicians only wanted to treat me for depression. But I only ever have depression because deliberately fleeing into a depressive mental state can be an effective, though desperate, way to calm the very harmful physical symptoms of anxiety. When I figured out both this pattern in myself and how to articulate it, I felt pretty frustrated for getting the wrong help (or attempts at the wrong help) for so many years.

A psychiatrist explained the systemic reason why that pattern of not treating the root problem happened to me — she said that doctors first go after what can kill you. Depression kills people, so they always want to treat the depression first and tend to regard it as more of an emergency. I said that was a good thing to know in terms of helping me find the right ways to insist on the correct treatment in the future.

Hey!! I am currently undiagnosed as an adult (mostly because I am afraid to be diagnosed, if that makes sense) but have dealt with anxiety since I was young. As a child I suffered with panic attacks for pretty mundane reasons. I did see a therapist for a few years and I learned to deal with my anxiety. When it finally seemed like I was “cured” though, my mother stopped taking me.
Although I havent suffered from any extreme nervousness or panic attacks like I did as a child, the anxiety never really left me. Its plagued me during my teenage years and as of late, has come back with a vengeance as an adult. With minor quirkinesses (like ocassional fear of taking a shower or being unable to leave the house without certain things).There has been times the anxiety has been bad enough that it has made me borderline depressive. I know that is enough reason to see a specialist, but the bigger part of me feels like maybe I am not messed up enough to require that level of attention. Or my number one reason which is that I am afraid to talk to my family about it. We are not very open with each other but I still live at home, so its something that would be hard to keep to myself. Not to mention that I think they all expect me to be much better adjusted than I really am.

I guess what I would like by joining this thread is to find others who are in the same boat I am, so I wont feel so alone. Recently, as a possible way for me to deal with my anxiety and stuff, I began a blog on WordPress under this name (goth27). Its not particularly full of useful ideas pr anything, just a place to be completely open and true and where I can let loose every single thought. If any one wants to take a look please feel free.

Hi goth27, you’re definitely not alone. I can relate to your experience of anxiety as a young person. I sought therapy when I was in my late teens, off my own bat, while I was still living at home with my parents. I organised my own transport despite being afraid of buses and not being able to drive. One day, my mother was going to the shops near where my therapist’s office was, and I asked for a lift. She asked me where I was going and when I told her the truth she burst into tears and asked me a lot of questions which made me feel like seeing a therapist was shameful and unnecessary.

Know that what you’re feeling is very common, especially among women (I’m assuming here, but even if you’re not, guys are no strangers to anxiety either). Know that there’s no level of “badness” your mental health has to reach before you ask for help, and that actually, getting professional help as soon as you can can maybe arrest the “badness” and help you develop good coping strategies for life. If you can see someone while living at home and it doesn’t stress you out too much, I’d recommend it. If not, there are some great resources for anxiety online, as well as discussion forums and even online CBT programs offered by some universities (e-therapy). Happy to link you if you like – just let me know.

Astral said: July 9, 201312:45 pm

From a former “maybe I am not messed up enough to require that level of attention” person, one of the few regrets I have in life is not getting myself into therapy the minute I moved away from home (where my issues and feelings were minimized and rationalized) for college. So I want to be your Go-to-Therapy-It’s-So-Wonderful-to-Be-Truly-Heard-and-Your-Feelings-Taken-Seriously cheerleader. One of the things that can be helpful is to learn how to have those conversations with family members who have unrealistic expectations of you and help you work through scenarios if you discover they are unwilling to accept that you are an autonomous human being.

I wish I had gotten that attention and relevant coping, mindful, cognitive, boundary-setting skills before I got as apathetic, self-destructive, and/or helpless feeling as I did.
Also wish CA was around then for the support!

cleverhound said: July 9, 20131:21 pm

Hi goth27,
As someone who suffered with a lot of anxiety before finally getting treatment, I’d say that if you feel that your anxiety is interfering with your life and your goals, then you can/should seek treatment. Anxiety isn’t a contest, you don’t have to have more anxiety than someone else in order to get treatment.

For me, I slowly began to wonder, what if I wasn’t devoting all this energy to bad thought spirals? What if I could simply do things instead of worrying over them for hours first? What if I could simply leave the house and go somewhere, instead of taking an hour of preparation first? What if I could go to more than one place in a day?

I didn’t know what that would be like. My therapist asked me to describe what my life would be if I was “better” or made improvement or progress, and I genuinely had no idea. My anxiety was an evil little gremlin, but it was my companion and had been for as long as I can remember, and I had no clue what it would be like without it. I thought I would be like that for ever.

I still have challenges, but I am able to do things that I never thought possible. Honestly, my biggest regret is not seeking help sooner. I think back on all the opportunities I missed because I was living in an anxiety bubble.

I guess I’m saying it’s ok to seek treatment. It’s also ok if you don’t feel like you are ready. Gentle hugs.

“Anxiety isn’t a contest, you don’t have to have more anxiety than someone else in order to get treatment.”
ahh thank you for this. Reading this thread, I am starting to feel like “Well, I’m not having fullblown panic attacks, maybe I am really okay and it’s not such a big deal that sometimes I can barely leave the house.” I am starting to ask myself a lot of the same questions you just listed and considering seeking treatment. Thanks for saying this.
Goth27, I am in a similar boat as yours. Undiagnosed and feeling like “Well, it’s not that bad, right?” I’m starting to wonder if maybe it could be a lot better, though. You’re not alone in these thoughts. Also, some of the comments on here about therapy are making me remember that when I first started therapy a little over a year ago, I didn’t think things were that bad. When I saw my therapist’s reactions to some of the things I told her about my childhood was when I finally realized, “Oh, maybe it was bad….” She’s also very helpful for picking out what’s going on and what’s anxiety and what’s not and how to deal with it.

Somebody who’ve I discussed my insecurity with and stuff and one of the very fee people I have confided in about maybe seeking treatment did mention before that it would be best for me since there might be something from my childhood or my home life that I might be ignoring or not seeing. She seems to think that maybe something as a child affected me deeply and took a toll on my self esteem and causes me to be anxious that maybe only a therapist can uncover. I honestly dont know what that could be since anything I perceive may have been the problem doesnt seem as bad. …but maybe I AM missing something.Also Cleverhound I would love some of those links please.

Hi goth27,
There doesn’t need to be a huge narrative arc of awfulness which caused anxiety in you for it to be valid, and worthy of treatment. Maybe there is; maybe there isn’t. A lot of it is thought by professionals to be inherited due to body type, kind of an autonomic hangover from the days where having a highly tuned anxious response to stimuli would help you run from the woolly mammoth about to gore you. It’s a less helpful response for computer-and-job stress or being side-eyed by a check-out person.
Also: there doesn’t need to be a big dramatic story behind it in order for your anxiety to be valid. I actually DID come from a kinda messed-up background (great in some ways, abusive in others) – and it wasn’t until I was in therapy that I managed to connect the two. However, even without that? I would probably get overly stressed by uni assignments, and computers crashing, and the thought of a relationship break-up.
Also – if you are feeling unworthy of seeking help or treatment, ask yourself: if a friend came to you with anxiety but they were unsure of whether it was “enough anxiety” to really deserve care, what would your thoughts be? Try to apply the same kindness you would apply to a friend, to yourself. The truth is, no one wins awards for dealing with mental health issues on their own, silently and stoically, for as long as possible. In my opinion, the sooner you can get a Team You and get good strategies for dealing with it, the better (obviously in a way which doesn’t make living at home even harder than it has to be).
Here are some of the links as promised, my apologies that they’re Australian-based as I am, but hopefully still helpful:
– http://www.anxietyonline.org.au/
– http://www.beatingtheblues.co.uk/
and various similar other e-therapy programs – I suggest finding one that is a good cultural fit for you and is accessible and cheap or free. Best of luck🙂

Mahvelous said: July 18, 201311:26 am

Hey Goth27, as the next commenter mentioned; there doesn’t need to be some huge, traumatic event or narrative in your childhood to have “caused” the symptoms you’re describing. I’ve met many people who suffer from anxiety and a common theme seems to be “if I could find out WHY (the one cause), I could FIX it.” there may be some truth to this, or it may be that your behaviors are the result of complicated chemical messages that are influenced by your environment, mood, stress level, past history, etc. (Also, it sounds like your friend may subscribe to some idea of “repressed traumatic memories,” which has been pretty thoroughly debunked within the psychiatric/mental health community).. Either way, I highly recommend talking to a good therapist about this: someone who you click with, who treats you well and has the same kind of green flags you’d want from a medical doctor. Speaking from experience, I find that I need a “tune-up” about every two-three years; I feel weird every time I seek out a new counselor, but I never regret it when I’ve finished “tuning up.”

keelyellenmarie said: July 10, 20131:17 am

“Reading this thread, I am starting to feel like “Well, I’m not having fullblown panic attacks, maybe I am really okay and it’s not such a big deal that sometimes I can barely leave the house.”

As mentioned elsewhere in this thread, I have had full blown panic attacks, and I have been severely depressed…but honestly, MOST of the anxiety and depression I deal with isn’t anywhere near that extreme, it’s more the every day background noise that makes everything harder. I used to think that only the extreme situations merited treatment… like I go in for this problem, get it cured, and now I should be done, right? And I happened to have therapy in a hospital building where I saw/occasionally interacted with people in much worse shape than I was, and I started getting down on myself for still needing therapy.

I started going on about it in therapy one day though, and my therapist responded by blowing my mind. He asked me how I would describe how I was doing at the time and I said “I get by. I’ll be okay, I’m surviving.” Then he told me that I was right, that was a big deal and I should be proud for getting myself to that point… but that our goal WASN’T basic function. He told me “Keely, you’ve SURVIVED all of this for years, with and without therapists. I believe you can ‘get by’ through anything. Our job now is to figure out how you can THRIVE.”

I immediately started crying. I have had so many people–professionals, family, friends–who basically think that if I’m not planning suicide or having panic attacks daily, I’m basically fine. I thought if I stopped being that bad, I would be wasting everyone’s time by continuing to use psych services. It honestly didn’t even occur to me that I deserved to not just be not-miserable, but to be actually HAPPY.

Basically, therapists are there to help you function and feel better. You aren’t competing with every other mentally ill person in the world to justify being there. If you are struggling with mental health issues that you haven’t been able to fix on your own, you should get therapy because you deserve do more than just survive.

“Panic attacks” are kind of the super hard end-of-level boss of regular panic. They’re when panic hits you so hard you cannot do anything else. That’s the point at which a lot of people who had formerly been limping along do go get help, because they’re about as easy to ignore as a foot falling off, but there are lots of grades of panic below “panic attack” that make life really. goddamn. difficult.

The point at which you’re “allowed” to seek treatment for this stuff is the point at which it interferes with your life. Except in certain special cases (e.g., you’re an axe murderer), the person who gets to pick where that point is, is you.

I just want to say you’re not alone. I, too, am undiagnosed and didn’t even suspect that my levels of anxiety might be higher than average until I started reading things about anxiety online. I figured if I could get through the day, it must not be a problem, right? In fact, I’m overwhelmingly anxious about even posting this comment. This article was posted yesterday, so what if I’m too late? What if no one cares? What if someone tells me that I’m not really that anxious, I’m just a whiner? (The last comment I made online, about something unrelated, I deleted after the first reply because I flew into a panic that the reply-er seemed to not understand what I was saying and I couldn’t cope well enough to even form a reply.)

I haven’t really talked to anyone about this, because again I have thoughts that it’s not “bad enough”. I just get so exhausted in my need to have control over absolutely every aspect of everything. Phone calls to order pizza (when they can’t be avoided by ordering online) must be rehearsed five times to make sure I don’t stumble over a syllable and make a fool of myself. I panic if someone other than me is driving a car (especially MY car — even my husband, who has never even had a parking ticket!– because oh god what if something happens and how will I deal with insurance and get to work and and and).

I was passed over for promotion several times at a previous job because people thought I was “unapproachable” because I couldn’t force myself to look up and smile or say hello to people in the hallways. It was just too much. I can force myself now to do that but there’s always this quiet narrative in my head: “Don’t make eye contact. Wait, you should make eye contact. This person is going to think you’re a jerk. Don’t pass them too closely — pay attention and anticipate where they’re walking! Don’t do that goofy little dance where you both try to pass in the same direction. You’re so stupid. Oh, god, they made eye contact, now smile. I SAID SMILE. That was a horrible smile, what is the matter with you? You don’t even know that person’s name and they probably think you are a b*tch. You shouldn’t even be allowed to go out in public for god’s sake!”

I pay extra for stuff at the store because I’m too nervous to hand the cashier a coupon. This is stupid stuff. I even KNOW it’s stupid but the narrative never stops. It’s exhausting. But I don’t think it’ll ever stop because I can’t even imagine myself talking to my PCP about this and as for therapy even the thought is too overwhelming to even know where to start.

And that’s my story. Which I’m going to post right now before I chicken out.

JenniferP said: July 9, 20136:54 pm

Your comment showed up! It just takes a minute because we’re not cleaning the moderation queue or spam trap every minute. Never fear!

Thanks! I didn’t get the ‘waiting moderation’ message the first time, so I wasn’t sure.

Emmych said: July 8, 20136:14 pm

Workarounds — augh, this is, like, the worst thing about anxiety. Workarounds are SO FUCKING HARD and you usually need to prep them pre-anxiety meltdown…which is, uh, sort of useless mid-meltdown.

The thing that I’ve found works best is recognizing my anxiety for what it is. When I start getting all kerfrazzled, I try to stop and think “okay, is this The Thing I am worried about, or is this my brain fucking with it’s chemistry again?” When it’s the former, I can take steps to minimize my anxiety! Example: “I’M GONNA BE LATE FOR WOOOOORK!” So I’ll shower tonight, lay out my uniform, set three alarms and hit the hay early. I feel more secure, and therefore calm down.
When it’s the latter, I tell myself to chill the fuck out (a thing I would only ever tell myself, ahahaha) and take a moment to calm down. Deep breathing, having a smoke, drinking a glass of water, whatever — I just do a thing that will keep me present and occupied for 5 minutes while I get calm. Sometimes I leave the room if the people around me are agitating me until I can trust myself to deal with them rationally.

One of my biggest strategies, though, is the ability to play the “nope.com I’m done @ done.net” card without convincing myself that I’m a huge failure face. This one is super hard for me, but by not knowing when to pack it in and trying too hard to be tough as nails and force my way through my shit feels, I end up doing more harm than good, and make my anxiety far more visible than it needs to be.

aaq said: July 8, 20136:24 pm

Your LATE FOR WORK workaround made me wonder how many Things I Do are actually workarounds for anxiety. I… think a lot of them may be.

And agreed with last paragraph. I drive myself as much as possible to social events and try and have a decent reason or two to leave if I need to because because yelling, “I’M LEAVING BECAUSE I AM FUCK OFF ALL OF YOU,” doesn’t do much for friendships, especially when we’re, inevitable, sitting around and playing checkers or some such calm thing.

I’m also someone who leaves early when feeling anxious. But the best thing for me is sort of checking in with myself about whether I want to leave and sometimes I realize that I’ve had a really great time, and if I leave now, my memory of the experience will be “had a really great time” whereas if I stay for another hour the message I end up with might be “got tired, burned out, I suck at social events.”

Lindsay said: July 9, 20137:30 pm

Huh. I never thought about it, but maybe this is why I almost always drive when my friend and I go places, or why I prefer to drive separately if possible, or why I also tend to have reasons in place in case I need to leave. It makes me feel less… trapped? Introversion + anxiety makes social interaction exhausting.

Marwen said: July 8, 20136:25 pm

“One of my biggest strategies, though, is the ability to play the “nope.com I’m done @ done.net” card without convincing myself that I’m a huge failure face. This one is super hard for me, but by not knowing when to pack it in and trying too hard to be tough as nails and force my way through my shit feels, I end up doing more harm than good, and make my anxiety far more visible than it needs to be.”

God, yes, to both the fact that it’s super important and that it’s super-hard, and often made harder by people who really cannot figure out what one’s problem is.

Carpe Librum said: July 9, 20137:25 am

One of my favourite Buffy quotes is, “I don’t want to deal with that right now. I am taking a holiday from dealing, happily vacationing in the land of not-coping.”

It’s okay to say, that’s enough copage for one day, I choose to put that aside for another time. Now, where’s my book?

Differentiating between The Thing I Am Worried About and Other Brain Shenanigans is helpful for me, too, but for slightly different reasons. Because when I’m really anxious about something long-term and situational (for instance, being new at my job or about to move across the country/just moved and trying to deal with a new place), my anxious!brain has developed the coping skill of creating OBSESSIVE AND TERRIFYING THOUGHT LOOPS THAT ARE ACTUALLY SCARIER THAN THE SITUATION WE ARE CURRENTLY DEALING WITH. Thanks, brain!

So, my method for dealing with anxiety is something like:

-Notice that I am anxious.

-Run Anxiety Diagnostic–Is the Anxiety…

A. An obsessive fear loop about something I did in the distant past (for instance: OH GOD I JUST REMEMBERED SOMETHING STUPID I DID WHEN I WAS TWELVE. I AM A TERRIBLE PERSON WHO DOES STUPID THINGS. I WILL SPEND THE REST OF MY LIFE DOING STUPID THINGS. MY LIFE IS A PIT OF DESPAIR AND DOOM AND STUPID, STUPID THINGS.)
B. Fear of something really concrete (making a phone call, a social occasion, an impending move).
C. Not tied to a specific fear, but just a jittery, fast-breathing, can’t focus or think feeling.

-If A, think about things that are really stressful in my life right now that might be causing my brain to think about That Stupid Thing I Did When I Was Twelve. (Do not engage with the fear loop of The Stupid Thing I Did When I Was Twelve or try to talk myself out of it, because my brain wants the loop to continue and will find ways to keep it going. Remember that my brain has a lot of practice creating fear loops, and that in the past, they have been unfounded. Remind myself that the fear loop will still be there later, and I can come back to it if I want.) If I can think of a specific, really stressful thing that is happening, move down to Option B Coping Strategies. If I can’t think of a specific stressful thing or the thing that was stressful is completely outside my control (for instance: something on that TV show I was watching reminded me of That Thing I Did When I Was Twelve), move down to Option C Coping Strategies.

-If B, is there anything I can do to make That Thing I Need To Do less terrifying? (For example: make a list of everything I need to carry on the plane with me when I move, write a script for the phone call, text my friend to ask what is appropriate to wear to her barbecue, ask my best friend to come with me?) Can I do that thing? If yes, do it. If no, either find a smaller thing I can do, or try something from the “If C” list and then come back. If there is nothing I can do to make that thing less terrifying, just move down to Option C Coping Strategies.

-If C, remind myself that I am having a baby panic attack* but that I know what to do, have lots of practice dealing with these, and that I’ll be okay. Get myself alone as soon as possible. Do something from my mental grab bag of calming things, which include listening to music while putting my hands on my belly to encourage deeper breathing; breathing in and out to a mental count; writing a worry list of everything that is bothering me (either in a journal so I can look back later if I am afraid I will forget those things or online at: http://thequietplaceproject.com/thethoughtsroom/ if I don’t want to remember them and would like to see them burst into tiny pieces); taking a walk by myself; doing some tai chi or yoga; watching a favorite episode of a tv show while breathing; focusing on feeling my feet on the floor while I breathe. Breathing is key for me, because if I can calm my body down, then my brain will often calm down a bit, too.

Another thing I do is remind myself that anxiety is something that happens to my brain sometimes, so it is okay to not be able to handle ALL THE THINGS if my anxiety is flaring up. If I need to be a hermit who does not do anything besides go to work, come home, feed myself, and manage my anxiety for X amount of time, then yes, that kind of sucks, but the world will not end. In fact, the world will still be there waiting for me to engage with it when I’ve gotten anxious!brain a little more under control.

*I say “baby” panic attack to differentiate from the other kind I get much less frequently, which is a bizarre, all over, “I feel like I just left my body for a second, and now I’m back in, and everything is new, and I am on hyper-sensory overload, and it is terrifying, and HOLY SHIT WHAT IS HAPPENING TO ME THIS IS THE SCARIEST THING EVER” feeling. (I find those much more terrifying, but YMMV and not everyone has both kinds of panic attacks–and some people might have a completely different kind that I have so far been lucky enough not to experience.) For those, I remind myself what is happening, get myself alone, and do whatever sounds manageable, whether that is sitting on the couch and crying, petting my cat, or trying to drown my body out until it gets its shit together by marathoning terrible tv.

WKP said: July 9, 20135:51 am

I really like your matter-of-fact way of talking through that. My biggest issue is that I have trouble separating Real problems from Anxiety problems. Your diagnostic method is great.

acoustic_alchemy said: July 9, 20139:00 am

+1 for the whole troubleshooting program. I’m a very detail-oriented person myself and have the annoying tendency of wanting to Fix Things Right Now, so attempting to defuse the ANXIETYBOMB all at once can be overwhelming. But by focusing on one thing at a time, it’s easier to set aside the larger worry of “oh-gawd-what-if-I’m-stuck-like-this forever” and cut the blue wire already (and I think I’ve beaten that metaphor dead :D) It’s a way of Making the Problem Smaller and calms the Ms. Fix-It bit of my brain.

When I have Type C situations, I found that doing something physically engaging but relatively easy and repetitive breaks my brain out of the anxiety loop, like rolling a cold marble in my hands or tearing a bit of paper. I’m wondering if this is the *healthiest* way of coping, but if answering this concern falls into Internet diagnosis territory, feel free to cut this out, CA.

Liyana said: July 9, 20135:32 pm

I am not a psychologist or anything approaching one, and I don’t want to stray into Internet diagnosis territory either, but the answer I’ve made peace with for myself is that any coping mechanism that does not hurt me or anyone else but which helps me manage my anxiety is a perfectly fine coping mechanism.

Like, back when I first started working with a therapist on my anxiety when I was a teenager, my therapist spent a lot of time trying to convince me that I needed to do the visualization and breathing exercises she gave me in a quiet room and that if I had music playing, I wouldn’t be able to relax fully or find my natural breathing rhythm because I’d just be breathing in time to the music or something. And after a couple of years of experimenting with her way and my way, I decided, “Okay, so maybe Therapist’s way of doing breathing exercises is the ideal one, but it doesn’t work nearly as well for me, so I don’t care. The goal here is to have less anxiety, and doing breathing exercises while blasting heavy metal is better at helping me have less anxiety than doing them in silence.”

Which does not mean that it is better for everyone to do breathing exercises while blasting heavy metal–that might be The Worst Idea Ever for someone else’s anxiety. Because brains are weird and not-standard, and I think the healthiest way to deal with anxiety is to figure out what works best for your brain (or what will work best for your brain right at this moment) and do that thing.

Red Kate said: July 9, 20136:20 pm

I also focus on one thing at a time. When faced with a situation that induced even the slightest anxiety, I break things down into very small increments and focus on those as much as possible, one at a time. It’s much harder in social situations, because generally you’re expected to pay attention to other people, which can be anxiety-inducing in itself. Then there’s TOO much anxiety. But, in the situations where I can break things down into tiny steps has actually allowed me to go through activities to completion several times, which has desensitized me to any dangers I thought where there (if that makes sense), and now I’m able to do some of these without a second thought.

I was specifically taught to focus on one thing, like counting all the red objects in a room, as a coping mechanism. I now use knitting, which is working pretty great! But I second the ‘if it isn’t hurting you, do it for now’.

Beth said: July 9, 20132:12 pm

I like the thoughts room a lot. Thanks for recommending it. It reminds me of a technique I learned through Dialectical Behavior Therapy for letting go of obsessive thoughts. You’re supposed to visualize them in some nature-y way and imagine the physical words crumbling or floating away. I like to imagine dropping them in a stream and watching them crumble and seeing the pieces float away. I think imagining thoughts as clouds that get blown past on a breeze is a common one.

Liyana, your Anxiety Diagnostic is SUPER SUPER HELPFUL for me to read right now. Many thank yous! I’ve been treating my type B anxieties as type A or type C, which means I never do any of those small concrete steps to make things less terrifying, and they just get more and more terrifying and my overall anxiety level creeps upward. Thank you for this sudden clarity!

Klik said: July 8, 20139:59 pm

I completely agree about the power of recognizing the anxiety for what it is. I have some social anxiety and in college often missed out on parties/group activities because I felt like no one really wanted me there and people were just being polite when they invited me places. Finally I made a rule for myself that if this was my only reason for staying home I had to go – I still felt awkward, but the rule allowed the logical part of my brain to step in and subvert the anxious part.

cleverhound said: July 9, 20131:27 pm

Oh yes, I have that brain conversation too. “Is this a real thing to be worried about or is it Anxiety Brain talking?” Of course, my following strategy is “Hmm, this makes me uncomfortable. I’m going to poke it for a while.” For example: I am having so much anxiety over sending this email. Why? I am worried that the person will give a nasty response. What kind of response? I’m worried this person will laugh at me and say there’s no way you can succeed in career thing. OK. Well, that is not really a thing that someone would say, and if they did, they would be a total asshole and their opinion wouldn’t matter. So maybe I don’t need to worry about that too much and I can send this email.

songofmyself said: July 8, 20136:20 pm

I have what I guess would be considered Generalized Anxiety Disorder (I’ve not gotten an official diagnosis for numerous reasons) and a pretty heavy social anxiety component. This is a combination of genetics (my mother and father are both anxious beings) and growing up in a house where mistakes were not tolerated very well and shame is high. Alas, even as a lad I was labeled a “worry wort.”

I tend to worry about anything and everything, and for a long time it was very difficult for me to control. My worry then would lead to paralysis and then depression. Sometimes it still does, if the stress is high. I’ve built up, through therapy, friends, and life experience, quite the arsenal of coping techniques along the way to help me cope.

I would say the first helpful step was expressing my anxiety rather than trying to control it. In secret I would try my very best to “get rid” of the anxiety, becoming irritable and ashamed that I couldn’t control it. So now I try to express it. I say it to myself, to my friends, to my partner, to the empty room: I’m anxious! I’m so very anxious! When I’m not in a place to do that, my loving partner says to me: you seem anxious. let’s talk!

The key for me to talking about my anxiety is talking about the anxiety and not the content. If I’m going to a party and I begin to worry that a) no one will talk to me b) everyone will laugh at me c) a gunman will come to the party and kill everyone d) we’ll be on the balcony and plummet to our deaths I don’t talk or ruminate about those things. I say: I’m anxious, and it’s making me think things that aren’t real. It keeps me from engaging with the anxiety in futile ways, rounding up statistics on balcony collapses and such. I remind myself that this is how anxiety works, and talk about that.

I gave my anxiety a name and visualize it as a person in my head. He’s very frail and scared and ashamed. And then I imagine my most confident, centered self giving my anxiety a hug. If Anxiety starts to talk about all the things that will go wrong, Strongest Self shushes him and hugs him tighter until he feels better. It might seem kind of out there, but it’s helped tremendously, especially on planes😉

All this. So so much, all this. (Except not the planes part, for some reason I feel really comfortable on planes.) But I also try hard to be kind to my anxious self. In stores, especially, which is where I tend to have panic attacks, I imagine my anxious self as a guard dog on hyper-alert and my logical self as the human being giving the anxious self a good rub around the ears and a treat for being alert, along with a “stand down now” signal. It doesn’t always work, but it actually helps a lot, if only because I remind myself that the panic is an instinct, just one that is currently misplaced.

“(Except not the planes part, for some reason I feel really comfortable on planes.)”

This baffles and amuses people. There are a skajillion things I’m afraid of, but I’m missing most of the common ones — spiders, snakes, rodenty vermin, speaking in public, new people… and airplanes. Moving across the country turned me into Simple Dog from Hyperbole And A Half, but I was perfectly calm about getting on the actual airplane. I happen to live near one of the takeoff paths for a major airport, and I find it strangely soothing to just go outside and watch the wing lights vanish into the distance.

Today I stumbled on an image of my anxiety as a “helpful” young cat. It’s adorable and means well and is big enough to look like it should know better and is not actually meaning to hurt when it drags the harmful coping mechanisms and terrifying thoughts out of wherever I stashed them. Because it’s helping, see, like “silly monkey you obviously can’t hunt for yourself so look I brought you a thing”, but it’s also not very wise. It has pointy claws to defend itself and cling to those things, too, even when it’s into something I want to get it away from.

i have also used similar techniques like what you describe about giving your anxiety a hug. i tend to dialogue with my anxiety from a part of me that feels more in control. it took me a very long time and a lot of therapy to have a bit of me available (although not always, sometimes i forget) to look after the other bits of me, but t i think that giving your anxiety a voice, then having an equally strong ‘friend’ type voice who can say soothing, loving things to the anxious part and can show understanding or encouragment is totally what helps me. it takes practice around self-compassion i found, and learning the kinds of things that soothe you when other people say them, or the types of things you would say to somebody you really loved who was so highly anxious. it’s one way i cope anyway, as well as extensive work arounds, as has been said by others. i have major phobias around eating and my health/dying which flare up from time to time and literally paralyse me with fear. one very random thing that comforts me is to sit in the bathroom with the shower running, because the running water soothes me. often though i have to resitrict my diet to ‘safe foods’, which has very little logic to it, but is just necessary when I am in that state, and sometimes i will have to just wait until somebody comes home to stand up to do basic life things (because of fear of fainting). it’s a pain, and has meant alsorts of horrible things happening such as wetting myself, and having massive sugar crashes, but that is the nature of anxiety, it can incapacitate. i tend to find that only my friends with significant mental health troubles of their own can understand in these situations, and most other people just make me feel more anxious and i need them to not come near me until i have calmed myself down. wow, i have gone on with myself now, but yes, i just wanted to agree with you about hugging your anxiety, it’s the best technique i have found so far, when i remember about it😀

cleverhound said: July 9, 20131:35 pm

I relate to everything you said! Parents, worry wort, all of it.

It is amazing how much identifying your anxiety can help. Instead of going into a frenzy, stopping and saying: I am having anxiety over x. For me, then I want to analyze more and say, well then y and z. Instead of letting the anxiety loops happen, stopping in their tracks.

Your anxiety person visualization is so kind. My mantra is “There is an anxiety monster that lives in my brain. It tells me lies. I don’t have to listen to them.” And then I stuff the thoughts/monster into a closet and seal it up. Hah.

Maddie said: July 8, 20136:22 pm

I recently survived a big party by finding the two people I knew there and saying this: “I’m not great with crowds of strangers, so I’d love it if you could introduce me to some people tonight. I’m not going to cling to you, but anything you can do to point me toward nice conversationalists would be great.”

That doesn’t help with the difficulty of talking to strangers, but it helped me to a certain extent (and I met absolutely fascinating people whom I will likely never talk to again but enjoyed briefly learning about).

cleverhound said: July 9, 20131:36 pm

That’s a really great strategy, as opposed to my usual one of hiding in corners and hoping someone will notice me. Love it!

does anyone else have the problem in which they try to talk to people about their anxiety, but the answer to “what are you anxious about?” is as daunting as “what are you sad about?” sometimes I have an answer, but a lot of the time, I do not. or if I do, I cannot explain why that specific thing is causing my anxiety.

Yeah. Sometimes I can pinpoint it, but a lot of the time it’s just… everything. (I started to write a big list of all of the things that I’m anxious about, but it was making me feel worse so I deleted it.) A hundred little things, some of which might happen, most of which probably won’t, all bundled together with some jacked up brain chemistry and a total lack of coping mechanisms.

meg said: July 8, 20137:24 pm

God yes! With people I’m close to, I try to explain that I don’t need things to cause anxiety, it will just latch on to what’s there. I call it having a Bad Day, because that lets me avoid mentioning the anxiety while alerting people to the reason I’m holding myself more tightly and responding less to their conversation. When they ask why, I tell people that nothing bad happened, it’s the day itself that’s bad, that sometimes days are just bad, in a very matter of fact tone.

prefixe said: July 8, 20137:47 pm

that is actually a really great way to deal with people. I have gotten really good at masking my emotions because I got sick of dealing with the constant “but what /exactly/ is causing you to make that face?” I might steal that from you.

Marwen said: July 8, 20138:33 pm

If I’m going to bring up the anxiety at all, it’s with someone I’m cool knowing I have the disorder (or who has to know whether I’m cool with it or not), so I tend to be pretty direct about it – “Oh, it’s a disorder, it doesn’t actually have to have a cause, it just latches onto shit and I get to be anxious. I’m going to go make some tea.” I find that if I’m super matter-of-fact about it, other people often are too, because otherwise they look bad.

MMV, of course.

prefixe said: July 8, 20139:00 pm

yeah, I would do that, but my anxiety has a huge impact on my life and a lot of times I have to tell people [even those who are not all that close to me] “I can’t do this today because of anxiety” and that brings on all of the questions from well meaning people who really don’t know anything about what I’m dealing with.

Marwen said: July 9, 201312:03 am

Oh, to be more clear, I’m not talking about people who are close to me – I’ve used the above on classmates, employers and in a couple cases complete strangers. I consider it about all the information they need to know, and sort of move on from there. “I have a disorder, it means my brain eats itself sometimes and I can’t do X today because of it. Let’s reschedule/not talk about this anymore.”

The big MMV is that I’m more comfortable cutting people off like that in my “we’re all polite strangers here, let’s change the subject” voice than a lot of people are, and I know that.

In my experience, people who ask “what are you anxious about?” really mean, “What actually scary thing are you anxious about?” And that question is impossible to answer (because the thing I am anxious about is not actually scary! That is why what I have is an anxiety disorder instead of a rational fear!) So, as you have found, even when you can name what is making you anxious, that doesn’t satisfy the questioner: they’ll keep re-asking, “But why does that make you anxious? But what about that is making you anxious?”

I have a lot of social anxiety. It was much worse when I was a kid. Having more than one person’s gaze on me filled me with fear that was so strong it hurt. Sometimes my parents would ask, “But why are you so afraid to raise your hand and ask a question?”
I couldn’t explain. I didn’t know why it hurt, I only knew that it hurt.
They might go on to ask, “Are you afraid that people will laugh at you?” And, sure, now that you’ve brought that possibility up, I am thinking about it, and now that I am thinking about it I think it would be very unpleasant indeed. But no matter how many times they forced me to do the thing I was afraid of, and then triumphantly pointed out that my fears were baseless because nobody laughed at me, it never helped. The thing that I was afraid of — people looking at me — did happen. And the fact that my parents would not have found it painful to be looked at somehow did not prevent me from feeling the pain that being looked at causes me to feel.

keelyellenmarie said: July 9, 20134:37 am

“And the fact that my parents would not have found it painful to be looked at somehow did not prevent me from feeling the pain that being looked at causes me to feel.”

That is the most heartbreaking sentence. Perfectly put, but damn.

redpen27 said: July 9, 20135:20 am

furthermore, in my experience, The First Rule of Social Anxiety is You Don’t Talk About Social Anxiety (Because Then Everyone Will Know You Are Needy and Creepy and Care What They Think; Hide It At All Costs!)–seems like my whole experience of social anxiety is kind of self-amplifying on some level.

nyb said: July 11, 20134:59 pm

Oh hell yes I have It’s So Much Worse If They Know in spades! Loop loop de loop…

bluecandles said: July 9, 20132:29 pm

I had this very same fear about raising my hand in class. I can definitely relate to that. My report card was constantly about me never raising my hand, or asking any questions.

Also, people trying to prove your fears are ‘baseless’? Doesn’t help. Just makes you feel worse for having those fears.

Urgh, so was mine, and eventually my dad blew up at the teachers, saying that they’d said the exact same thing for years and since I was getting good marks and happy enough it clearly wasn’t a problem, so why didn’t they let me be quiet and leave the question-asking to those kids who actually felt the need to ask questions. It was very surprising and heartwarming.

I really relate to boxofdelights about the irrelevant baseless fears -in my case it all boiled down to being unable to know or control anyone’s thoughts, and the fear that they could therefore be negative. Hooray for social anxiety and difficulty with social cues feeding off one another in an awkward spiral.

bluecandles said: July 11, 20131:53 pm

Your dad wins for that.

I have a similar awkward spiral. Hooray.

flpsychgirl said: July 10, 201310:10 pm

I once had a psychiatrist who tried that logic with me. “Whats the worst that would happen?” “What are you afraid of?” “If people laugh, just laugh with them. Its ok.” It helps me a little, after the fact. But yes, I can empathize with the pain of ‘all eyes upon you’ (or even just some eyes, strange eyes, judging eyes). And for me that means fidgiting, then turning red, then the panic sets in. But for me its really just this overwhelming feeling that’s there’s something wrong with me, that I don’t belong, that I’m doing something wrong, even if I’m just standing there, and they KNOW! They can tell by looking at me that I don’t belong, they can see what’s wrong with me! I feel like Hester in the Scarlet Letter, except what’s wrong with me can’t be removed with my clothing.(mind you, I am a perfectly normal looking female, a little on the heavier side right now, but even back in my size 2 days I experienced the same thing) I’ve walked out of the grocery store before because I couldn’t stand in line with everyone looking at me any longer. I know it seems rather narcissistic to think that anyone would even bother looking at me, let alone judging me, but…

gardenia said: July 13, 201311:14 pm

It took me a while to articulate that part of my social anxiety had to do with a fear of being looked at / stared at / judged. I was finally able to describe it as feeling like there was a giant glowing red neon sign hanging over my head, with big vertical letters spelling out STUPID over a big arrow pointing down at me and flashing, so no one could possibly miss it.

Oddly enough, one of the ways that therapy helped me the most both with articulating this and learning to tolerate it, was the fact that my therapist’s studio had large mirrors on two walls, and she would always let her clients go into the studio first and be there alone for a few minutes before joining them. So in those few minutes, every week, I would practice just *standing* there in the middle of the room. My reflections in the mirrors, if I didn’t look directly at them — and of course I couldn’t look directly at both of them at the same time! — felt like “someone looking at me”. Except I knew it wasn’t *really* someone else, which stepped down the intensity enough that I could start to be aware of the feeling and then practice tolerating it. At first I could only do it for a few seconds, but I would do it as long as I could, before looking down and sitting on the floor or otherwise out of line of sight.

But I still vividly remember that big blinking red neon sign feeling, and sometimes I still get it.

Yes this happens to me alot. I think alot of the time for me its not so much the answer itself that is difficult to find, but the fact that I am afraid that the answer is not good enough to justify why I feel anxious. Same with the “why are you sad?” question. I dont feel effed up enough to justify me feeling depressive.

prefixe said: July 9, 20131:43 pm

yes, I think that’s exactly what I was trying to say. the things that I feel anxious about are often not things that “worth” being anxious about to most people. and sometimes I don’t even know what is causing my anxiety, I just have it and it won’t go away.

Yes. It makes no sense sometimes. For example, I like to shop, especially for clothes. But sometimes there comes a moment after being shopping that I will start feeling anxious for absolutely no reason. There was one time in particular I was shopping at one of my favorite stores and out of nowhere I started to feel very anxious, so much so that I started to pull my hair. And so all enjoyment got sucked out, just like that. I was done, I didn’t want to look for anything else, I barely wanted to go pay for the stuff I had already gotten and all I wanted was for my sister to hurry up so I could get the hell up out of there. That is the worst. And trying to explain people why you are having a mini-panic attack in the middle of your favorite store to shop in is highly illogical to explain.

One helpful thing I heard was that the lack of a decent reason to be depressed is exactly what makes it depression. This may or may not apply to individual circumstances.

BiancaSnoozes said: July 9, 20139:13 pm

This exactly. This is the thing that keeps me from seeking any treatment. I am absolutely positively petrified of having to explain myself to a doctor. To the point where if I even thing about going to the doctor, I start crying immediately. And then I think about, well what if I make an appointment and go in and sit down and can’t do anything but cry and say “I don’t know.” I have an HMO-style health insurance that has a mental health section, and I’ve read it over and it says that at your first appointment you will be asked why you are seeking treatment and about your childhood. Those two things make me so anxious about going that I can’t bring myself to do it.

I’ve also stopped talking to my best friend because if I even mention that I’m having a hard time on a certain day, I immediately get a call from her, and she’ll say “What’s wrong? Tell me, I’m worried about you.” And I just get so much anxiety about getting that phone call that I’ve stopped telling her when I feel bad. I know she’s trying to help and that she cares, but it actually just makes me feel worse.

Maybe you could write down a paragraph saying why you are seeking treatment and a short description of your childhood, and hand it to them? I bet you could even bring more paper and let them know upfront that you will be writing your responses to their additional questions? I have no idea if that would help or not, but I know sometimes I shut down and just CAN’T SPEAK and I have to choke out “I need to text this to you instead of speaking”. I know this won’t work if it’s all forms of communication that you have a hard time with, but I thought I’d throw it out there.

JenniferP said: July 10, 20138:37 am

I did this when seeing a new physician. Wrote out a paragraph about my history with a certain issue – timelines/treatments tried – and gave it to her. It helped her not have to start from the very beginning.

Mental health pros are used to dealing with recalcitrant folks. It’s ok to have friends or family members dial and make the appointment. It’s probably ok to bring some kind of short written statement. It’s ok to say “I’m really nervous about this and don’t know how to start.” I know there are a lot of not-good doctors out there, but hell, even my dentist asks about people’s fear & past experiences with dentists on his intake forms so he can be aware and treat you well. If a therapist you’re considering won’t roll with how YOU need to communicate, it’s a sign that this person might not be right for you, not a sign that you are doing it wrong.

Oh goodness yes! For me, one thing which helped tremendously was getting the actual diagnosis of Generalized Anxiety Disorder. I had an excellent psychiatrist who explained that part of the problem that I was just generally anxious. Some people had specific things they were anxious about. Me, it’s a background anxiety about … life. There are other specific triggers, but there is an overall background.

Free-floating anxiety has one big thing in common with depression, which is that often the actual answer to the question, “What’s wrong?” is “Fuck if I know.” It’s extremely frustrating when you’re talking to someone who wants to SOLVE THE PROBLEM! and they think you’re not telling them what it is because you’re afraid it’s embarrassing or stupid. No, I really have no earthly idea why I’m curled up in a ball on my desk chair sobbing, it frustrates the hell out of me, too. If I had any idea what I was scared of, I could do something about it.

prefixe said: July 12, 20137:36 pm

this is basically everything I feel about my anxiety 93% of the time

Tired Caregiver said: July 8, 20136:25 pm

I have a very specific form of social anxiety…I’m absolutely fine once I’ve settled into a situation, but it’s incredibly hard to take that first leap if I’m not sure of the tiniest detail of the social rules for the situation.

For example, I really wanted to start getting massages. The thought of meeting the massage therapist didn’t make me nervous…it was all the other ‘stuff’. Do I tip? Do I remove all underclothing, or just my bra? Does one talk during a massage? Most people would worry about these things if they weren’t sure, but for me it’s like a dead stop…it makes me feel utterly sick to NOT KNOW.

This extends even to very simple things like ordering pizza over the phone from a new place. Will they ask for my security code for my card? Will they ask my full name or phone number? I realize none of it matters, but my adrenal system is over there sounding the call to arms for no good reason.

My way of dealing with it is just to admit to it and seek out the information I need to feel comfortable. So for the massage thing, I went to a few health forums and just asked “Please explain the process from start to finish and any unspoken ‘rules’. I have anxiety issues and it would help a ton.’ And people did just that…I did get a few “Come on, just do it! Geez, what a wuss!’ but overwhelmingly the feedback was supportive and tremendously helpful. Or for calling a new place I’ll have a friend order the first time so I can listen in on the process. I don’t know if that would be helpful for anyone else, but it works pretty well for me.

But when it comes to joining new social activities, none of the above helps because every group is different. I would LOVE to join a gaming group, but what if they have ‘house rules’ for their social stuff as well as their boardgames? Strangely, I don’t have any problems understanding social dynamics or cues…but it still terrifies me that I might not ‘get’ the group IMMEDIATELY and do something tragic like suggest D&D on a GURPS night when everyone knows that just isn’t done. It would be easier if I had friends who already belonged to such groups and could give me a ‘primer’ on the social underpinnings, but that’s not the case. This has pretty much stopped me from joining any activity even though I’m pretty much desperate for social interaction.

aaq said: July 8, 20136:32 pm

I wish we had a *fistbump* button or something because take “massage” and replace it with “therapy/counseling” and you have me.

The things that I’ve seen lately with people posting their therapist’s “This is Perfectionism” handouts have at least helped me to group this with other behaviors, which, for me, was useful.

I’m also kind of here to get any other replies to yours, so yes….

Tired Caregiver said: July 8, 20138:00 pm

Oh, me too!! I’ve been thinking about therapy more and more lately. I live with my mother, who has some major health problems and issues with her memory, and I’m really starting to struggle. I could really use someone to talk to, or maybe a support group for caregivers. But it’s just like with the gaming group…what you can expect seems so much more varied than, say, ordering pizza or a massage therapist.

I did, however, get my mother to (briefly) visit a therapist, and she has some of the same issues (but her anxiety is much more generalized than mine.) I was the one who made the appointment, and when I told the therapist that mom was anxious about how the appointment would work she asked to speak to her and explained the process. It made me realize that with a therapist, it’s one of the situations where you can straight-up say “I’m nervous about this, please walk me through what to expect.” And if they won’t do that before the appointment, they probably aren’t the right therapist anyway!

I am more in the depression than the anxiety camp, but for those who have serious anxiety obstacles around getting into therapy/counseling, I wanted to suggest that online therapy is getting to be more of a thing. The only organization I’m familiar with is Pretty Padded Room, which is rather specifically women-oriented, but there are probably others out there? With PPR, at least, you can do video chat or more indirect stuff like a two-way journal, which might be a good workaround for some folks.

cleverhound said: July 9, 20131:43 pm

The best advice I can give you is that if anyone ever is going to be comfortable with your anxiety and understand if you mess up/are awkward/whatever and want to make you comfortable, it is a therapist.

These things vary so much, but Tired Caregiver is spot on with asking for more information. Like at my therapist office, each counselor schedules with their patients individually, so you leave a message, and the therapist will call you back. There isn’t a secretary. A (good) therapist is going to be so willing to talk you through the process. Maybe you could call the potential therapist on the off hours to hear their answering message, to see if that gives you more info (like for mine, it says to leave a message, others might give you their operating hours).

So much this. A lot of my (undiagnosed, because of basically this reason) anxiety comes in the form of “But I don’t know what to do!” What if when I call the bank to find out about my car loan, they ask for information I don’t have? What if I go to a car place to get my oil changed and find out I had to make an appointment? What if I invite someone I’d like to be friends with to see a movie but they work that day? I recognize, rationally, that these aren’t actually huge problems; regardless, on a bad day (or even just a not particularly good one) they’re paralyzing.

As I said, it’s a huge part of why I’ve never seen a therapist of any sort, even though I’ve been dealing with anxiety and maybe depression for most of my life, and even though I’m pretty sure I can get it for free through my insurance. I don’t know the process. I don’t know how to call. I don’t know where to find out who to call.

You type in your zip code and get a list of licensed therapists in your area. Each of them has a paragraph or so describing their interests and approach. Therapists, in my experience, are great on the phone, so once you manage to pick one that sounds good and dial the number, you can say, I don’t know how this works, and let them take it from there.

Freya said: July 9, 20135:16 am

Or email. I emailed the therapist-group-business-practice-thing my therapist was with, and asked some questions, and they said that the person who ended up being my therapist sounded like a good fit for what I was after, and asked if they could give them my contact details. I said yes, and said therapist and I talked enough over email that I was happy with the details before I went in. Even knowing that I paid after the appointment and I should have my (Australian) Medicare card ready was helpful!

Carpe Librum said: July 9, 20137:48 am

I am so much better at written rather than verbal communication, because I can go back, re-read, edit etc and Use ALL My Words, instead of just blurting out something that was supposed to be humorous or clever but now I’ve said it just sounds odd and not quite appropriate.

charcoalhibiscus said: July 9, 20137:26 am

I started by getting a recommendation from my school’s online anonymous post thing. (Like ISawYou[School] or [School]FML). That way I knew that at least *someone* liked the therapist. If you have any friends who can give you a recommendation, that’s a good place, or maybe try an online forum for your area if not.

Mine happened to have an online form submission so I didn’t have to talk to anyone initially (thank goodness- clearly they understand. It would have been 249857 times less doable if I had to personally pick up the phone and call someone) and then someone called me back to schedule an appointment. But if that’s not the case for you and you have pick-up-the-phone anxiety or write-the-email anxiety like I did, you might try having a sympathetic close friend or family member make the call for you.

The other thing I did (and this may have just been the anxiety talking, but it worked for me) was I steeled myself for needing to shop around a bit. There are many therapists out there, a goodly number of whom are great and a goodly number of whom suck, and I knew that if I told myself “ok, once you get in you’re golden” and then ended up with a sucky one, I wouldn’t have the energy left to do it all over again to get a better one. So instead I told myself, “ok, you’re done with step 1” and then was pleasantly surprised instead when I got a good therapist🙂

I asked friends for recommendations, and I had my best friend write down a list of questions to ask. She would have held my hand when I called but I didn’t need that. You can ask for help from people who already know you and it is okay.

Ok, so do you tip? Do you leave your bra on? I have these exact barriers to getting a massage, and I probably could really use one!

Liyana said: July 8, 20137:47 pm

I used to work as a receptionist at a massage clinic, so I have answered these questions for a living!

Tipping is appreciated/encouraged/somewhat standard (rather like when you get your hair cut at a salon), and the standard tip is 20% of the price of the massage.

You can leave your bra and underwear on if that makes you feel more comfortable, or you can take them off if that makes you feel more comfortable. You’ll be draped by clean sheets the whole time, so it’s really down to personal preference.🙂

Tired Caregiver said: July 8, 20137:55 pm

From what I’ve gathered…tipping is appreciated unless the massage therapist also happens to be the owner of the business (which would not be typical). I heard 15-20%- kind of like a hair stylist. How much clothing you remove is to your comfort level, but for best results the bra should probably come off because it’ll be a bit in the way. Most people seem to prefer to be fully nude, but a number did say they kept their panties/boxers on. You’ll have a sheet to cover you, and the therapist will only expose the body part they’re working on, so you won’t be as exposed as you think. People suggest heavily communicating with your therapist…it shouldn’t HURT, so if it does, you need to speak up. You should tell them any particular problem areas and if you have any medical conditions.

Really, I heard over and over that communication is key and you should be very up front and KEEP communicating throughout, at least until the therapist gets to know your body better.

I kept my bra on the first time, but now I take it off and keep my panties on just because I won’t relax otherwise. My massage therapist works for my hair salon, so I asked my stylist to suggest the one with the lightest hands. I had a SUPER BAD experience with a massage therapist that turned out to be one of the most painful things I’ve ever gone through, so I was super nervous even beyond my usual anxiety. I was upfront about that and let her know I have major problems in my neck/left shoulder, and she’s been absolutely great about not hurting me. I’m very, very glad I finally went for it!

Badger Rose said: July 8, 20138:12 pm

The bit about being covered by a sheet and only being uncovered for the part you’re working on was a big deal, and something I didn’t know before my first massage. Even if you strip all the way down, you’re not going to be in, um, full view the entire time. You have a sheet over you, and one arm or leg or shoulder or whatever is uncovered at a time.

This does mean that the masseuse will see part of your bare butt or part of your breast, so if that’s going to be weird, you can totally wear your bra/underwear. But even if you don’t, it’ll just be pieces in isolation, not total nudity all at once.

Badger Rose said: July 8, 20137:56 pm

I get massages!

I always tip, around what I would tip for a restaurant meal (ie, 20% as baseline).

In my experience you can keep your bra/panties on if you want, or not if not. In general they will tell you what they expect; most of the time you’ll get in the room and they’ll say, “You can undress and put your valuables (eyeglasses, watches, whatever) on that shelf, and put your shoes and clothes here, and then lie down face-down (or face-up, depending on how that masseuse starts) and cover yourself with the sheet.”

In general if they say that that means that you’re welcome to strip all the way down. (On rare occasions I have had a masseuse say “leave your underwear on” in which case that’s what you do; if they just say “undress” they mean “you can take it all off.”) If you want to leave your bra, your underpants, or both on, you can say just, “I’m going to leave my underwear on.” In my experience they will basically always say, “Okay, whatever makes you comfortable.”

If you want to leave all your clothes on, that’s usually also fine but it’s also usually a different massage type, so that you’d want to mention when you make the appointment. (That way they know not to warm oils for you or etc.) But undressed-except-for-bra-and/or-panties, you can just let them know at the time you show up.

I have done massages with bra and underpants on, with just underpants on (if I’m getting a massage around my period, for instance), and with nothing on (most common, once I’m comfortable with a place). I’ve never had anyone give me any hassle for any of those options. (And if they do give you a hassle, that’s not normal, and it’s a perfectly good reason to cancel, FYI.)

MamaCheshire said: July 8, 20138:50 pm

I had a friend who was a massage therapy student, and I had one of his classmates do a practice massage on me. The default at this particular school was underwear stays on, everything else comes off. I think that when Spouse has had professionally-given massages, that has also been the expectation.

Badger Rose said: July 8, 20139:03 pm

I could easily believe that it differs by region, school, or etc.!

The safest thing, probably, is to ask at the disrobing point (if you aren’t instructed).

I think the important thing for purposes of this discussion, in terms of underwear-on or underwear-off, is that BOTH are standard enough in the world of massages that no one will think ill of you for either, regardless of a particular place’s “default.” If you strip down to skin, they won’t be thinking “what an exhibitionist!” And if you keep your underwear on, they won’t think “what an uptight prude!” They’ll just think “that’s what they’re used to from wherever they’ve been before.”

Or if you say “this is my first massage,” any masseuse worth his or her salt will leave it to “whatever you’re comfortable with.” Because it’s supposed to be relaxing, and if your state of undress is stressing you out, it won’t be. So they leave it to you. And they know that your comfort level will be a product of a lifetime of conditioning, and what you’ve been told to expect, not your character as exhibitionist or prude.

At my place, they asked me if it was my first massage and had me fill out a questionnaire (I remember thinking most of the questions were dumb, but I can’t remember specifics), then they showed me where the lockers were and asked me to undress, leaving my underwear on, and put a robe on (which was a large, so I was terrified it wouldn’t fit, but it was very roomy).

We start with me sitting on the massage table, robe on, and I close my eyes to smell the oils and pick my “sensory journey”. Then she leaves, I take off the robe and get under the sheet on the table, face down. When she comes back in, she starts with my back and pulls the sheet down, tucking it into the waistband of my underwear.

When it’s time to flip over, she covers me fully with the sheet, reaches and grabs the far side and holds it up to visually block the view of me turning over. I have to scootch down at that point, because my face was up on that thing that cradles your face so you can breathe face down. When it’s done, she leaves the room so I can put my robe back on, and waits in the hallway so I can find my way back to the locker room.

Obviously YMMV.

Lost Seabird said: July 8, 20138:34 pm

Thank you so much for writing this. Just reading it and knowing I’m not alone is really comforting. Like, I really really need to get my car washed but because I have absolutely no idea what the procedure for that is, it stays filthy and I feel like everyone at work is judging me for it so I park really far away and pretend it’s not mine. I’ve told my boyfriend not to just take it to the car wash for me like he has in the past in the hopes that enough filthy-car shame will force me to act.
Can we start, like, a manual of how to do everything? That should exist on the internet somewhere. I mean, it would be better if I could just go do things without knowing how they work, but until then…
Okay, back to lurking for now. My anxiety or depression or whatever else in my brain right now is telling me that everyone that reads this post will think it’s stupid and hate me for it so I should just delete it. I am ignoring that.

Tired Caregiver said: July 8, 20139:29 pm

See, that’s just the type of situation I mean…it seems like something basic, you know, but we actually aren’t born knowing this stuff. I’m slowly getting better at accepting that and becoming more comfortable asking questions. Sometimes I’ll make up a one-shot e-mail so I can join a forum and ask a ‘simple’ question without feeling too embarrassed. I’m the type of person who feels most comfortable with routine- like I always park in the same spot, go to the same stores…and I think it’s all tied in together. Like getting a massage or going to the car wash is something new, and until it becomes routine I’m going to have a private little meltdown and do super secret research in a desperate attempt to feel more comfortable.

But thank you for replying, because I honestly thought I was alone too! Usually when people talk about anxiety it seems like they’re mostly talking about social anxiety, mostly centered around meeting new people. Or general anxiety. It’s reassuring to know afraid-to-do-stuff-I’m-assured-is-simple-but-really-it’s terrifying-because-it’s-new anxiety is something other people can relate to.

I’ve always thought I was the only one who felt like she’d missed the day in kindergarten when they gave out the Life Instruction Manual. I’ve learned that, in the long run, not asking the questions causes more trouble than the few moments of feeling dumb, so I try and make myself ask. I may preface them with, “So this is a dumb question, but,” and say them with a huge friendly smile, and offer much thanks afterwards, but I know that it helps me to be sure I’m doing it “right” and most people don’t mind being asked for help. Those that do make it clear enough you know in seconds to never ask them anything anyway.

And Tired, your comment about things being uncomfortable until they become routine, wow, light bulb moment. One of my big self-soothing coping mechanisms is going to Target, where I have a set routine and go through every section. I’m also big on always folding the laundry the same way, all my meds being in a set order. Routine is very calming, isn’t it?

Tired Caregiver said: July 8, 201311:36 pm

I think, unfortunately, that some of my issues came from being told as a child that ‘everyone just knows’ certain things, so why didn’t I? It was mostly about fashion stuff, which to this day I am absolutely hopeless with. I routinely wear plaids with dots, and 99% of the time I’m in PJs. I just don’t ‘see’ how things go together (and in the end, I just don’t CARE.)

So when I was young my mother would tell me to go part my hair…and I genuinely did not know HOW. I mean, I could run a comb through, but I didn’t know where the part should go or why. And instead of explaining, I would just get told ‘Come on, everyone knows this stuff! You’re not stupid!” So I got it in my head that not knowing something ‘everyone knows’ makes you dumb and useless, even if you do know a lot of other really great, interesting things.

And even if, in reality, no, everyone does NOT know. Parting one’s hair or scheduling a massage or washing the car…none of that stuff is instinct. It took me forever to internalize that!

On routines…oh, yes, so calming! I hate this conversation at the mall so much:

Mom: Let’s park at Penny’s, I have a card there.
Me: I’m parking at Sears.
Mom: Why do you always have to park there, it doesn’t matter where you park, blah blah blah
Me: If it doesn’t matter where I park, why are YOU making such a big deal out of it?

That’s the other thing it took me forever to internalize. There are parts of my anxiety that I want to work on because it actively interferes with my life, like having to work so hard to get a massage and wanting to join a social group. But there are parts I DON’T need to stress about, like parking at Sears over Penny’s. You actually don’t have to ‘fix’ it all…if I never park at Sears, what does it matter? If parking there makes me have a better day, then where’s the problem? I can fight against the jerkbrain and the anxiety, but I also get to pick my battles.

Freya said: July 9, 20135:25 am

Tired Caregiver, in my experience, it takes more energy to find the car if I parked somewhere other than my usual spot. Some days I can. Some days, I don’t have the energy to spare. At dancing, my regulars think I’m not there if I’ve parked somewhere different, and they tend to find it quite startling to walk in and find me😛

(I got my driver’s license after starting to learn how to dance; part of my logbooking involved driving from work to a particular dance venue in another instructor’s car. I parked in one particular spot because that was the only one I felt comfortable I could park sufficiently well in as a beginner – it’s got good guidelines, and it’s wide. I’ve been parking there ever since)

(This is a reply to Tired Caregiver, since the comments are nested too far)

Mom: Let’s park at Penny’s, I have a card there.
Me: I’m parking at Sears.
Mom: Why do you always have to park there, it doesn’t matter where you park, blah blah blah
Me: If it doesn’t matter where I park, why are YOU making such a big deal out of it?

It took me a really long time to internalize this as well. My husband will go to the grocery store to pick up bread, get a different kind than usual, and then when I mention it (because I am also a ridiculously picky/non-adventurous eater) he’ll act like I’m being totally ridiculous. “It’s just bread! Why does it matter what kind we get?” But I’ve come to the conclusion that if it’s just bread, and he doesn’t see why what kind we get matters… why doesn’t he just get the kind I’ll eat? If he cares so little about it that he basically just grabs one blindfolded, why can’t he just accept that I -do- have a preference? (We’re working on it, but I do the vast majority of the grocery shopping anyway. Because while it would be ideal that he would remember and go along with my myriad restrictions and preferences, he doesn’t right now and it’s my responsibility to make sure I get food that I’m willing to eat.)

VA said: July 9, 20133:37 pm

I’m so glad you didn’t delete this post, because I would absolutely read The Manual of How to Do Everything!

I am the same way, and like to seek out lots of information before going into a new situation. My husband is really great about understanding this and, if he’s been somewhere before, he’ll explain to me in very specific details (“This is where you should park, this is how you get out of the parking garage, then you turn this way and go up an elevator, turn left and walk through a hallway and check in at the counter on the right, and then you’ll see a sign on the wall…”).

Re: the “manual of how to do everything,” it’s only for stuff related to finances and work, but I love Cap & Compass’ book “life after college.” It explains things like how to enroll in a 401(k), how to rent an apartment, and things to watch out for during a business dinner. Internet forums are also great for getting tiny questions about unspoken expectations (like the massage thing) answered.

I actually literally did a ride-along with a friend who was anxious about car washes. I loved it when mom did it with me as a passenger but always felt funny doing it as a driver. I still don’t get them often but I am getting better.

Simone Lovelace said: July 11, 20139:23 am

Your post is not stupid, Lost Seabird! In fact I think it’s pretty great.

Accepting that “not knowing how to do a thing that needs doing” is a normal part of being a grownup was revolutionary for me. I spent years assuming that the reason I couldn’t [find my keys/cook/dance] was because I was just *inherently incapable* of doing those things, and hence was TERRIBLE HORRIBLE OMG THE WORST.

Everyone has to learn how to do grown-up things, one way or another. Needing to learn how to deal with the car wash isn’t a sign that you’re failing as a grownup; quite the opposite. It’s a sign that you’re on the right track!!🙂

Ali said: July 11, 20139:45 pm

Car washes: you can do the kind at the gas station where you drive through or you can do the kind at an actual car wash place like Auto Bell. The procedure is similar for both.

For the kind at the gas station: depending on the gas station, you may be asked if you want to have a car wash at the pump (I know this is how Sheetz, in the mid-east US, does it in at least the locations I’ve been to) or you may be able to drive up to the entrance of the car wash and select it there. You pick what level of involvement you want, but just a wash should be fine to start so go with the cheapest option. You then drive into the car wash machine. Stay in the car, keep all of your windows closed, and if you have a delicate antenna you probably want to fold it down/retract it first. The machine will put soap all over your car in jets. It’s loud but I don’t find it unbearable and I have sensory processing issues from autism. After the soap it will pressure wash the outside of your car. There are traffic lights inside the machine that tell you when to pull forward and when to stop/park. When the wash is over, it will indicate you can pull forward. In some places, there may be an air sheet you drive through slowly as you exit to get the car dry. Pros: cheap, fast. Cons: loud!

For the kind at a car wash place: a lot of these are semi-automated. You drive up and stop where the attendant or lights indicate. You choose which level of cleaning you want (again, the baseline is probably fine for now) and then get out of the car with your valuables. If you have anything big, just put it in the trunk. Leave the keys in the car or give them to the attendant, whichever they indicate. You can then go wait inside with bad tv and coffee while they move your car through a machine that’s similar to the gas station one, and often there is a component after where they vacuum the inside as well. They will generally alert you when your car is done, but I always felt more comfortable watching and going out when it was finished. I think you’re supposed to tip, but not much–a dollar or two–unless there are signs saying no tipping.

I have other types of anxiety as well as this, but this, augh. I’m good at picking up social cues and reading emotions and such, and it’s rare that a mistake made while calling a credit card company or seeking a therapist would be dire, and yet! I must know every single possible thing about the thing I am about to do, and still often want or need someone to do things for me, just so that I can see how it’s done.

Nymerias said: July 9, 201311:06 am

I relate to this so, so much. I NEED to be prepared for things in order to do them, which results in me googling all sorts of simple “how to _____” things. And I’ll ask my friends extensive questions about things they’ve done or places they’ve been that I haven’t. Even though I have no dietary restrictions and I’m not a picky eater at all, I almost never go to restaurants without looking at the menu, and sometimes I won’t eat at places that don’t list their prices online. I’m not sure what I’d do without the internet. Maybe get on with my life because I’d be forced to? Or maybe be a recluse and miss out on all sorts of things. I’m glad I don’t have to find out!

acoustic_alchemy said: July 9, 20134:53 pm

Holy crap, I do internet research marathons for doing new things all. the. time. Old things that need a refresher too, now that I think on it. Just now I was googling “how to write an email to a prof”. The Internet has been a godsend in this regard, and oftentimes I jokingly refer to it as my “second brain” because things that I don’t already know how to do, I can just look up without fearing scorn that I’m [x] years old and still don’t know how to do [y]”.

Flip side of this though is the hangup that I *have* to look all this stuff up, because if I have to ask a person in meatspace how to do something, clearly with all of the information I have on my hands that I could look up in seconds, I am clearly too lazy to do my own work and how dare I inconvenience somebody who was Born Knowing How to Adult with my incompetence

The internet has been such a huge help to me in this regard! If I’m traveling, I can write up extensively detailed itineraries (“I get on this bus, at this time, at this stop here (handy map included) which will cost $x.xx weeks and I get off at this stop (insert map 2). And the first night, I can eat at this restaurant, which is only a block from my hotel!”) weeks before I go, put them on my phone, and have them constantly available, in order to reassure myself that I do, in fact, know what I’m doing. Without that ability, I would be much less likely to travel places by myself.

Or I can look up common procedures in various situations. Last week, I decided to start doing lap swimming at the local pool, but I’d never done that before and was terrified of doing it wrong and, I don’t know, pissing people off or, really, just having them *notice* me. So I googled “lap swimming for beginners” and there were all kinds of websites talking about pool etiquette! And yeah, I had to sit in my car for a few minutes before I went in, so I could talk myself into actually entering the building, but once I went in, I knew what to do. And I could tell myself that I knew what to do, which I generally find immensely helpful.

peewhy said: August 4, 201311:11 am

Oh gawd I know what you mean! I need to know, and I rely on the Internet as well. I get a little stressed whenever I don’t know what I’m supposed to do, but I’m getting better at asking people than going on the Internet frantically on my phone.

cleverhound said: July 9, 20131:45 pm

Oh, I know what you mean. Massages are hard. I asked my mom, who had one at the same place I was going to. I still find it really hard to relax and people are touching me and ah.

Generally, I try to think that if a group is going to make fun of me for getting something wrong that I didn’t know about, then maybe they are assholes and not a group for me. (This is a major coping strategy for me: If someone responds in that way, then possibly the are an asshole and need to go away. Not my problem, their problem sort of thing.)

E.C. said: July 9, 201311:03 pm

“This is a major coping strategy for me: If someone responds in that way, then possibly the are an asshole and need to go away. Not my problem, their problem sort of thing.”

This was a huge realization for me in regard to my anxiety issues. I used to feel like, if I approached a particular task, phonecall, etc. in a nonstandard way out of ignorance or asked a question about how it’s done, and somebody laughed or yelled at me for it, that meant I Failed and basically shouldn’t be let out in public. Nowadays it still stings, but I’ve internalized a little better that maybe I’m not the one being a jerk here.

H.Regalis said: July 9, 20132:03 pm

“I would LOVE to join a gaming group”

Gaming is awesome! (Well, I like it anyway). I hope you get to where you feel ok joining a group and that you have lots of fun.

Not sure if this is helpful, but these would be my basic things based on my time gaming so far:

-Show up on time.
-If it’s at someone’s house, bring a snack. This is not required every single session, but it’s a nice gesture.
-Don’t be on your phone the whole game ignoring what’s going in front of you.
-If it’s an RPG and you’re just starting out, **pick a character class that doesn’t require massive amounts of memorization**. My first D&D character was a barbarian and my attacks were basically, “I hit it with my axe” and “I hit it with my axe again” which sounds boring but I could take out tons of enemies and it was much easier for me to pick up the game vs. the people who started as a wizard and never bothered learning any of their spells (or how to cast spells for that matter).
-If a board game makes no sense to you the first half-dozen or so times you play, don’t worry about it. A lot of games have a million billion moving parts (Arkham Horror, I am looking at you) and take a while to pick up.

JenniferP said: July 9, 20132:23 pm

If anyone is in Chicago, the Chicago Game Lovers group has regular “newbie” nights where they happily let people try out new things and teach rules, etc. It’s to sort out exactly this thing, so people are less nervous about jumping into the regular flow. They will also go over rules at non-newbie nights and the expectation is certainly not that everyone will intuitively grasp every single game the first try. Also, my anxieties are not social and do not extend to board gaming, but I also have to ask for rules & expectations, have things clarified, forget what the turn order is in, etc. until I really get the hang of something — PLENTY of people do. Nobody (as far as I know) hates me or thinks I’m bad because of this. Sometimes we’re all figuring out a new game together, sometimes there is an experienced player who takes on the role of rules interpreter & game tutor. I know that doesn’t take away the anxiety, but in my experience people are really helpful and forgiving. There are a few people who are really irritating to play with, not because they don’t know things but because they mock others for that and try to police everything. THEY are the ones doing it wrong, and quickly have a hard time finding anyone who wants to sit with them.

I think anyone who runs a gaming group that’s inviting new members would be pretty receptive to “I’m a newbie, what do I need to know?” questions before a meetup.

VA said: July 9, 20133:29 pm

I used to have this experience with restaurants. Because sometimes a hostess seats you, and sometimes you seat yourself, and sometimes you order at a counter and pay there but sometimes you pay at a different counter, and the menu is unfamiliar and I feel like I’m holding the line up while I try to decide what I want… It was easier to just not go to the restaurant rather than risk the judgment that would undoubtedly ensue when people realized I didn’t know the “rules” of that particular place.

Lindsay said: July 9, 20137:45 pm

Wow, I feel this so much. Basically I fear anything where I don’t 100% know what the outcome will be, or exactly what to do at each step in the process. It’s the reason I avoided answering the phone at work for so long, because what if the person asks me a question and I don’t know the answer, what if I accidentally pick up the wrong line, etc. etc. So instead of doing a lot of things I would like to do, I avoid them because it’s easier than trying to stamp out each fear one by one, since I can never know what will happen for sure beforehand.

DFTBAwkward said: July 10, 201312:56 pm

This won’t help all the time, but if you’re ordering pizza from a chain (and even some nice/well established local places, at least in my city), they usually have an online ordering system you can do via your computer or a phone app without talking to anyone! It’s a godsend for people with anxiety.

eat24hours.com serves a lot of cities as well, and they take PayPal. Handiest thing I ever found. There have been more nights than I care to admit where I would not have eaten dinner if I couldn’t order food via the internet.

UK people can use justeat.co.uk for similar phone-free ordering! Thanks be for the phone free ordering!

WKP said: July 8, 20136:36 pm

I have emetophobia and sometimes it really upsets me how almost all discussion of anxiety seems to be focused on social anxiety just because its more common.

Esti said: July 8, 20139:18 pm

I also have emetophobia! It’s gotten better over the past few years and I think I was always on the milder end, but it was and is definitely there. I sympathize on anxiety discussions tending to focus on social anxiety, it’s actually never really occurred to me that phobias are relevant to these discussions (which in hindsight seems silly on my part).

I suspect that the issues people encounter with social anxiety are probably different than with a specific phobia like this — I know that pretty much everyone who knows I “hate vomit” think it’s funny, and no one really understands how strong an aversion it is or how upsetting it can be.

I don’t really have anything helpful to contribute on this, but I just wanted to say that I’m with you on this and I hope others will chime in on it.

I have OCD and I know the feeling. For me, it’s really hard to talk about anything that’s not social anxiety/social scrupulosity type anxiety in public because people don’t seem to get it even when they understand more social types of anxiety. I’m sure it’s different for you – OCD gets enough attention that people at least think they know what it is, whereas I’m sure most people don’t know what emetophobia is – but maybe we can hang out in the “still anxious, just not like that” corner together.

Zee said: July 8, 201310:33 pm

So much empathy here: I suffer (boy, do I suffer) from claustrophobia. Because there are very few people out there who truly enjoy being crowded or cramped into small spaces, it can be hard for people who aren’t phobic to understand that there is a meaningful difference between “well, of course, no one likes to be cramped” and “if I step into that elevator my heart might explode”. For me, it has been very helpful to meet other people who are phobic, regardless of type. (One of my oldest friends suffers from agoraphobia and we’ve joked with each other that it would be nice if we could just balance each other out somehow.) There’s a real sense of understanding that I get from other phobics that is rare in people who don’t have first hand knowledge of what it is like.

WKP said: July 9, 20136:06 am

Yes, that’s exactly the problem! I try to avoid telling people about the emetophobia for that reason. I’m perfectly happy to tell people I’m depressed, have panic attacks, have an anxiety disorder, am too scared to leave the house, am underweight because of anxiety/mental issues… But I never want to tell people what’s the root cause of all of it. Because its impossible to express how bad it is. Because “No-one likes being sick”.

It’s hard to describe the difference. But I guess the simple way is that ‘normal’ people who find being sick physically unpleasant , still don’t really think about being sick unless they actually ARE sick at the time. Whereas emetophobes are sick much, much less often – because they’re so good at stopping it. But despite that, I spend 90% of my waking mental energy thinking about being sick. Wondering if it might happen. Thinking about what I’ve eaten, where I’ve been, who I’ve touched. Imagining what it would be like. Telling myself its possible to stop it from happening. Checking how my stomach feels – do I feel Hunger, or Something Else? (Yes, those are the only two options for me).

So the line between a phobia and a normal dislike of something is not about how you react when the thing happens (ie, “I have a phobia of spiders, every time I see one I run away”), but about how much it effects you when the thing is NOT happening (ie, “I have a phobia of spiders, I can’t go into the shed because I’m not sure if there’s one in there).

Actually, maybe OCD has more in common with phobias than I realized – I tend to get “yeah, I like to put my books in alphabetical order too!” which… sounds pretty similar to “yeah, I hate being sick too!”

When the whole point is that this may be something that comes from a rational fear at some root level, but it’s not rational anymore and trying to be like “oh yeah, I totally get that except I’m not crazy about it” is pretty much the opposite of helpful.

Tired Caregiver said: July 8, 20139:40 pm

Oh, I have this to! To the point where earlier this year when I did start vomiting I knew something was REALLY wrong and ended up in the hospital for three days because my bowels shut down. The fact that I couldn’t fight it off like I normally do was a big clue-in…before that point I had successfully avoided vomiting for over two decades.

I can’t watch movies or shows that show something vomiting…and it’s always scary because you don’t always know when it’ll be shown, and there’s no genre or show that’s safe from it. It shows up in comedy as a joke, in drama because the character is drunk, in horror because someone saw something gross, etc. And I’ve always had a big issue with public restrooms out of fear from being in there if someone had to vomit.

I will say that bout of vomiting this year actually did help…a lot of my fear came from a bad experience as a child. It was deeply, deeply unpleasant, but it wasn’t as terrifying as I remembered it beginning. I fully expected to have a panic attack or start crying, but that didn’t happen. I ended up getting a very nasty stomach virus at a con a few months later, and already knowing I could handle it (as much as I loathed it) made spending the day stuck in the hotel bathroom easier.

There used to be a movie review-type site that had a very comprehensive list of EVERYTHING that happened in a movie that could be unpleasant, and vomiting was including, but I can’t seem to find it now. I also don’t have much advice, just sympathy!

Tired Caregiver said: July 9, 20131:00 am

Talking about phobias…I have a really strange one involving small, round objects. Specifically small, round objects standing alone. Like a pile of peas is okay, but a single pea by itself makes me gag. I guess it’s not a phobia in terms of a fear, but rather a severe aversion…seeing it makes me physically ill. I really have no idea where this comes from…it isn’t like I choked on something small and round as a kid or something.

I’ve learned to keep it to myself, because every last time I’ve ever brought it up (Like, hey, could you PLEASE stop dropping grapes on the floor because it’s making me sick?) people think it’s HILARIOUS to put small, round objects in my path. I do not understand why people in general think phobias are so funny.

I turned down a job once at a veterinary clinic because one of the techs there was phobic of insects and during the interview the head vet chased her around the building with a box of crickets. She was outright begging him to stop and crying, and everyone was standing around laughing their asses off. DOES NOT COMPUTE.

Any tips for disclosing a phobia without the follow-up ‘let’s actively try to expose you to the thing you fear/hate?’ BS?

Ellen said: July 9, 20135:15 am

I have a terrible phobia of hedgehogs, which most people think is hilarious because they are slow-moving herbivores that can’t hurt you! I have no idea where it came from, but because they’re a native species in my country, growing up my classrooms always had pictures of them. Nowadays my phobia is so severe that I can’t even look at a photo of a hedgehog – even some drawings or cartoons of them set me off.

I sometimes disclose it this way: ‘I have a very bad phobia of hedgehogs, I cannot even look at photos of them. For example, if you were to show me a photo of a hedgehog right now, I would scream a lot and hyperventilate, and I would have to leave and I couldn’t spend time with you again. Yeah, it’s THAT bad!’

It helps that I don’t find it offensive when people say ‘Really? Hedgehogs? That’s weird!’ because I sort of agree with them, it IS unusual. So I can explain the severity of it in a light enough tone (‘I have this strange phobia and THIS IS HOW SEVERE IT IS. Isn’t that interesting? That it is so severe? You have noted the severity by now, of course.’) but they have still been told what the consequences are if they push the boundaries.

I am fortunate in several ways that not all phobia sufferers are – I rarely see the thing I’m afraid of in real life, people can’t just produce one of them at will (although a photo will have close to the same effect on me, and smartphones are a thing), I don’t mind talking about it because I’ve learned to do so without imagining what I’m talking about, so when I give my ‘this is what will happen’ speech, I am not imagining any of those sensations. I am just reciting a script which could as easily be about the best place to get a bagel. Not everyone is in that position.

But yes, people who think phobias are funny – not nice people.

lilaengelrocket said: July 9, 20133:32 pm

i read thru a bunch of these different descriptions of phobias but it didn’t hit me that i have one of my own until i read about Ellen’s hedgehog phobia. i am terrified of taxidermy. i have never met anyone who feels the same way. i have been known to turn on my heel and book it out of museums when i come to an exhibit of stuffed animals.

i grew up near a university with a natural history museum on campus which houses a panoramic exhibit of different habitats of the world filled with specimen from those habitats. i used to go to this musem all the time with my family as a kid but i usually just lingered in the doorway of the panorama. the last time i went there, they had taken one of the polar bears out of the glass case and put it by the front desk. i took one look and ran. i literally sprinted out the door, down the front steps and a little ways down the main road of campus before stopping to catch my breath and slow my racing heart.

i have had nightmares about falling thru the glass and getting trapped in the panorama. i have had nightmares about being trapped in a closet with a stuffed black bear. i have had nightmares about being forced to stay in a mountain lodge filled with hunting trophies. i cannot be in the same room as these things. i have had to leave restaurants and shops because i noticed a deer head on the wall. antlers and horns creep me out, too, but not as much. bones and just plain dead things don’t really bother me at all, except for the same obvious reasons most people would be bothered by those things. it makes my stomach turn and my skin crawl to see other people touching taxidermy. cryptozoology is some of the worst.

my theory is that it has something to do with the uncanny valley because sometimes mannequins and sculptures make me uneasy, too. altho, robots/androids and statues generally do not. i think it’s the idea of something being lifelike but not alive that freaks me out. i can’t be sure. i don’t remember when this started. it’s been an issue forever. i admit that it’s pretty weird and i don’t even really get it. i’ve never met anyone with the same aversion even tho plenty of people think taxidermy is gross. i don’t mind being made fun of to a certain extent and, fortunately, most people don’t have any taxidermy lying around to tease me with.

WKP said: July 9, 20136:24 am

That’s interesting – and weird! My cousin actually has a similar thing, to do with things bring small than they should be. A TV programme where two rich people make a be – but the bet is only for 50p, for example. In his music class, they played the shortest song ever, it was half a second long. And he got a panic attack from that.

As for the disclosing thing, it’s really hard. I think a lot of it has to do with context. If someone tries to bring it up in a social situation where there are other people for example, or in the middle of doing something (and I mean brings it up by asking about it or something) – its hard to have the conversation in a way they will understand the severity. In my experience, its best to have the conversation under these circumstances:
1. You are not currently anxious, upset, or angry. (This means it wouldn’t be ideal for you to do this while you were upset by them throwing grapes on the floor. In that situation I’d suggest that you try asking once, and if it doesn’t work, then simply leave the situation.) This is important because if you are obviously upset, then your words can be discounted as the product of extreme emotions, and therefore be ignored once those emotions appear to be over.
2. You initiated the conversation. This gets across the message that you have chosen to tell them, and allows you to dictate the tone and seriousness if what you are talking about.
Once those criteria are met, I think Ellen describes the best way of actually saying it. Be blunt and specific.

Ellen said: July 9, 20138:16 am

WKP, I love your first point – the situation I described above, where I disclose and share the consequences at the same time, is something I’ve only done when not actually panicking/being confronted with a hedgehog. If I was confronted with one, getting the hell away fast would be my only priority and I wouldn’t even think about how to disclose!

I also hadn’t considered the fact that initiating the conversation can be a position of strength, but it occurs to me that I had noticed that before, I just hadn’t made the cause and effect connection.

I also have a pretty strange aversion. Big groups of things freak me out. It doesn’t matter what they are; I don’t like crowds of people, schools of fish… one time at work, a piece of equipment was covered in a bunch of little stickers and it just creeped me out so hard I spend half an hour peeling them off and cleaning the equipment so I couldn’t see the lines anymore. I can’t really explain it, but it just… makes me feel weird. Wrong. I actually feel a lot better knowing that apparently having an aversion to relatively normal things isn’t unheard of.

WKP said: July 9, 20136:12 am

Wow, I really appreciate you posting this. Its really reassuring to hear that your anxiety was red after you got sick. Like you, I haven’t vomited since I was a kid – about 5 or 6. I never had a specific traumatic experience, but the fact that it’s been so long means I cant remember what its like – so I assume it’s the worst thing imaginable. I truly believe that when I am eventually sick, my anxiety will be so bad that I’ll simply die. Thank you for posting this.

Tired Caregiver said: July 9, 20135:16 pm

I know some people with severe emetophobia will force themselves to vomit to try and break the obsessive thought cycle. From what I understand, they usually choose to do so with friends nearby who are willing to be reassuring/intervene if need be. From what I’ve read, results are mixed…it really helps some people, others not at all (like everything else in life, I suppose.)

I know for me, I was really quite shocked…I have the same obsessive ‘Am I nauseous or just hungry? Wait…am I nauseous now?” thought pattern you describe. So getting so sick taught me two things…first, what nausea ACTUALLY feels like, so now I’m not so panicky every time my stomach burbles or I get heartburn. And second that no, I won’t die, and even better…I won’t even feel like I’m dying. I had built up so much anxiety around the entire thing that when it actually happened it was kind of like…’wait…is that ALL?’

WKP said: July 9, 20135:30 pm

So, did you not get a feeling of disconnect from reality after so long of trying not to be sick and suddenly realising that, actually, “right now the thing I’ve been dreading my whole life is actually happening this moment”? I feel like when it happens to me I will somehow dissociate because I have spent so much energy trying to be a Person Who Doesn’t Vomit. So when I do vomit, I’ll be.. someone else? Or stop existing altogether?

Also I’d love to ask some specifics of you if you wouldn’t mind: How long ago was this episode of vomiting you mentioned? And how quickly did your emetophobia anxiety in general decrease after it happened? And how consistent has the decrease been (i.e., has it got worse/better/stayed the same over time, since then)?

Tired Caregiver said: July 9, 20137:03 pm

Some background first…I was diagnosed with IBS at 13. Basically, I used to get really bad stomach pain and diarrhea, and spent a great deal of time thinking about my belly and how it felt. Eventually I learned how to eat foods that didn’t set off my belly and these days I’m about 95% ‘cured’ so long as I stick to the right foods.

I say this because it illustrates how I’ve always spent a lot of energy thinking about my stomach/food/the possibility of getting sick. So I know what you mean about the disassociation…for so many years I was ‘the person with IBS’ and everything in life revolved around it.

But when I learned how to eat right, or learned I actually could throw up without falling to pieces, I didn’t dissociate, die, or disappear. Now I was just ‘the person who used to have IBS but got better’ or ‘the person who used to obsess about vomiting and doesn’t anymore.’ It’s a thing that happens, and then you come out the other side and you haven’t changed…only some of your feelings have. You aren’t your feelings, though…you’re just the space where they happen.

The first incident, basically I felt perfectly fine one minute and was in terrible pain the next. At first I just thought ‘crap, this is a really really bad IBS attack’ because that does still happen on occasion. Then I started shaking uncontrollably and I couldn’t tell if I was nauseous or not (because again, at the time EVERY stomach ‘thing’ equaled nauseous.) When my mouth flooded with saliva I realized nausea actually does feel very different from anything else. I actually only threw up twice, and not very much, but I still felt like I needed to for several hours (but was able to hold back.) At the hospital I was still pretty panicky over the idea of vomiting more and kept begging the nurses for assurances the morphine and other meds wouldn’t cause it.

When it got better was months later when I caught the stomach virus at the con. This time was much more intense…I vomited repeatedly throughout the night and well into the next day. It was also scary in that it came on with very little warning.

But because of the previous bout I already knew how it was going to feel and what would happen, so I didn’t get the same anxiety and I didn’t fight it, which meant I could vomit and get some relief for a while before it happened again. Not fighting it helped a great deal and kind of broke the thought cycle that I NEEDED to fight it because it was the-worst-thing-that-could-happen. I kept thinking between bouts ‘Okay, this isn’t bad.” Then it would happen again and I’d be like “Okay, it is pretty bad. But not THAT bad.” I didn’t realize between the hospital and the con that I’d started to think about vomiting differently and wasn’t as scared as I’d always been.

That was in March, and I still feel like if it happened again now I’d be okay and wouldn’t panic.

Nymerias said: July 9, 201311:14 am

I believe kids-in-mind.com might be the site you’re looking for! It’s super descriptive about violence, sexuality, substance abuse, and other possibly triggering or upsetting things in movies. It’s designed for parents, but totally useful. I should probably use it more often than I do. It’s one thing to be prepared for unsettling things in horror movies, for example, and another thing entirely to be blindsided by them in comedies (I’m looking at you, Pitch Perfect!)

Oh my gosh I love that site! I am sensitive to violence and gore (I resonated with Susan Cain’s description in Quiet of a Highly Sensitive Person) and I look up every movie before I go see it to make sure I can handle it. If nothing else it gives me a heads up of when I will need to close my eyes.

Chickie said: July 13, 20132:03 pm

I know sometimes in big fandoms posts will circulate on tumblr with both more conventional trigger warnings (things like gore, suicide, abuse) and less-common ones (one that’s really helpful for me to know is if there are depictions of panic attacks or severe anxiety). I don’t know of any site that has them reliably for different kinds of media, but maybe someone else can help with that?

E L said: July 12, 20139:15 pm

The IMDB Parents’ Guide section often lists scenes involving vomit, in addition to gore, sexuality, alcohol/drug use, etc. (I usually read the Parents’ Guide before watching a movie or tv show because scenes involving sexual violence can trigger a panic attack for me.)

The downside is that because the Parents’ Guide is user-generated content, the entries are sometimes incomplete or weirdly phrased, and it often includes spoilers. It can be worth reading, though, for viewers with phobias or specific content issues.

JenniferP said: July 12, 20139:19 pm

Not vomit-related, but Does The Dog Die? is a way to check in advance if a movie contains animal injury or death. I find it very helpful to avoid one of my particular unhappy places.

I don’t have this, but I do have a very very VERY strong aversion to medical stuff. (Is there a name for this, I’ve never had it diagnosed because see above.) I have a hard time pinning down exactly what bothers me but I can’t watch ER, or House or any of that without holding my face closed for half of it. I can’t stand hearing descriptions of medical procedures. I can watch SOME horror/thriller gore stuff, but not others, and it is hard to know what will bother me. (Stuff that looks really painful or anatomical no, vague gore, yes.) Just thinking of having to go to the hospital make me feel all panicky.

And lord help me if someone has visible stitches or wounds. I once had surgery and when we took the bandages off my mom had to catch me when I fainted. I also once fainted from having a doctor read me the medical description of Mono.

I probably need to get a medical advocate or something, because if I ever am seriously ill there is like a 50/50 chance I’ll be able to handle hearing what the doctor is telling me and a 0 chance that I will be able to make decisions about it.

This sucks for a couple of reasons, 1. I ACTUALLY CANNOT sit here and have a conversation with people about past injuries and how horrible they were. No, really, stop telling me about your surgery, I’m not just being dramatic.

2. I avoid visiting people in the hospital, and when I do I invariably have to go to the restroom to have a panic attack. Which makes me feel like a jerk because I want to be doing something nice for them. (See exhibit B Social Anxiety.)

3. I’m unintentionally rude to people with disabilities once they reach a certain level of me not being able to deal with it. One of our friends just lost half of his hand in a machine accident. I just have to pretend it didn’t happen and never look at his hand or I may totally freak out, which makes me feel like an ass.

What bothers me the most about this is that I actually think I should be able to rationalize my way through it. So sometimes when I feel that first twinge of anxiety I try to just push past it. (Like a drunk person in front of the cops, MAINTAIN.) So then sometimes I’m fine and other times I’m fainting or having a panic attack.

redpen27 said: July 9, 20135:43 am

@shinobi42 somewhat in the same vein, my boyfriend is panic-level scared of anything that involves slicing or cutting skin (everything from violent beheading scenes in movies to hearing the word “papercut”) and talking/hearing/thinking about AIDS or blood poisoning, and–i don’t think this is necessarily healthy, but it does work–i run interference for him. like “close your eyes, i’ll tell you when this scene is over” and “really, you guys, don’t talk about AIDS in front of boyfriend.” i bet getting someone to go to the doctor with you would help!

Katie S said: July 9, 20137:26 pm

I have this, too. I don’t know what it is called and never thought to look for a diagnosis. (I do have a diagnosis of social anxiety and am taking Lexapro.) Unfortunately, I work at a company that makes medical devices (!) and the in-laws are both in the medical field and think that discussing surgery and other medical procedures in detail is perfectly acceptable dinner-table conversation (!!!), and I’m the one being rude if I ask them to stop.

I have had to leave the room at work when people in an adjacent cube were discussing surgeries, and I get light-headed and nauseous during the Red Cross first aid classes every. single. time. and I’ve probably taken the class 8-10 times. The descriptions of burns are the worst for some reason. I keep thinking it will get better with exposure, but it never does.

The strange thing is that if I actually have an injury or have to attend to someone else’s, I’m fine. I can even watch a surgery if I have a job to do, like, “Please watch carefully to see if X happens,” but if I’m just called in to “observe” I freak out and internalize the pain I’m seeing. Fortunately people at work are pretty understanding about this. Internalizing the pain happens when I watch a movie, too – I physically feel an injury that I see on the screen.

DFTBAwkward said: July 10, 20134:40 pm

Oh man, I have this too! A little differently than some of you, and more mild than shinobi, but yeah. I can watch movies with FAKE gore (I love horror movies!), but when it’s a surgery show (real or fake) I can’t watch it without feeling uncomfortable/queasy. I once passed out in high school when the class was discussing what tuberculosis physically does to your lungs, for example. Every time I’ve tried to give blood I’ve passed out from anxiety (and I feel super guilty about this). This summer I’m doing legal support work for an abortion clinic. I want to be here, I believe the work is valuable and I am completely pro-choice. But I am sitting here in the clinic right now knowing surgery is going on in the next room and I just have this base-level queasiness/anxiety that won’t go away (absolutely NOT related to the moral part, no qualms there–it’s all the medical/surgical part that gives me anxiety).

Any coping strategies or advice on therapy would be seriously appreciated!

DEA said: July 9, 201312:40 am

Dear God, thank you for saying this and thus causing me to google it. That’s what I have. I never thought there was a name for it – I just thought it was a weird quirk of my anxiety manifesting itself physically, but looking back, most of my worst anxiety has centered around “what if I vomit here?” and has gotten worse and worse. I’m going to have to bring this up when I see my doctor soon because holy crap, that is absolutely me.

WKP said: July 9, 20136:29 am

I’m glad to have helped! Emetophobia is actually one of the MOST common phobias. And yet many doctors and therapists don’t know about it, and most people don’t understand it.

Yeah… I have a generalized anxiety disorder rather than social anxiety. I tend to be social and gregarious, though introverted. My anxiety is just Chicken Little running around claiming the sky will fall. I get twitchy about whether I have enough money, whether my plants and cats are OK, whether I’ll get in trouble at work(thanks, authoritarian, mercurial dad … am outright phobic of authority figures yelling at me)… stuff like that. Or my brain will decide to freak out over nothing at all. Or it’ll decide from spotty ‘evidence’ that something awful happened(ie: mom.didn’t respond to latest text plus dad called equals mom.is dead). Not. Fun.

My main coping mechanism is a mental construct inspired by the daemons in Philip Pullman’s His Dark Materials trilogy. They’re entities that take animal forms and provide companionship and advices to their human, whom they’re part of. Mine is of course essentially an imaginary friend, but he’s developed a good amount of independence in my head, and acts as my anxiety auditor, sorting and digging through the feelings so I can properly cope. He insists I do self care things, and reminds me to be gentle with myself. And he’s kinda comforting just to.*have*. It’s helped a lot with self affection… after all, he is me, and thus is my way of being my own friend.

I also take Buspar for anxiety and Prozac for depression, which… seem to help.

redpen27 said: July 9, 20135:31 am

oh man, the “deductions from patterns of phone calls/not phone calls” freakout is one of my regular ones–feeling you on tat. also the “if i don’t tell my boyfriend to be careful every single morning he will be hit by a car while riding his bike” superstition, which somehow feels related.

redpen27 said: July 9, 20135:29 am

one of my dearest friends has this and i’ve seen that it’s quite a struggle for her. sending you good vibes…

VA said: July 10, 20139:37 am

Re: emetophobia. I have never been formally diagnosed with this or even heard of it until this thread, but it’s resonating with me. If comments are still open, I’d like to share my story. The only other person who knows about it is my husband, because I feel so embarrassed about it.

I have anxiety. Some of the anxiety is what people have called the “free floating” or “low level” kind, the constant worrying about safety/relationships/career/doing something stupid/being judged, trouble falling asleep, etc. It’s there, but it’s not debilitating. I’m a “high-functioning” anxious person.

I also have IBS. It started in high school and was poorly managed (unmanaged, really) throughout HS and college, mostly because my parents thought it was just a “nervous stomach” and my doctor had no idea what it was, so therefore it must be in my head. It wasn’t until I did some research on my symptoms as a young adult that I even knew what to ask about. Now the IBS is under much, much better control, although I still have flare-ups. Unfortunately, it’s existence is a big trigger for my anxiety, and involves a lot of work-arounds. I plan my meals very carefully, so that I only eat very mild foods if I’m going to be traveling or have an important meeting the next day. I carry Pepto and Immodium with me all the time, just in case. I always need to know where the nearest bathroom is. Worrying about having a flare-up is enough to cause one sometimes.

I don’t have social anxiety, but I do have a lot of anxiety in social situations centered around food, because I’m worried about being sick to my stomach and not making it to the bathroom in time. My roommate in college thought I had an eating disorder because I was constantly getting up during a meal to go to the bathroom. Nope, just painful, urgent IBS. So that’s part of my anxiety too: what assumptions are people making about me when I get up to use the restroom?

For the past year I’ve had what I now know to be occasional mild panic attacks. They aren’t debilitating, and they don’t match the assumptions I had about what a panic attack is, so it took a long time to figure out what they were – the original diagnosis was “delayed motion sickness” (?). I get very overheated even if the room is cool, all my clothes feel too tight, my legs and hands tremble from the adrenaline, I get short of breath, and I feel terribly nauseous and my stomach cramps. They have almost always happened in situations where a) I’m with a group and there’s food involved, and I feel pressured to eat and not bail, and/or b) I don’t have immediate access to a bathroom.

I’ve had to sneak to bathrooms and be sick to my stomach because the panic attacks have made me so nauseous, and now I have anxiety about throwing up in front of other people, or people finding out I’ve just thrown up.

Thank you so much for putting a name to this. Does anyone else have anxiety that manifests around a gastrointestinal disorder? How are you managing it?

WKP said: July 10, 201310:13 am

It must really suck to have IBS along with anxiety. I think that your ‘type’ of fear would be best described as some kind of atypical social anxiety, because it’s focused on what would happen if you got sick / had an IBS flare-up in a social situation or public place.

In fact, although its good to learn about similar and related types of anxiety, it’s also really important to make those kinds of distinctions. For example, CBT for a ‘straight’ emetophobe like me will pretty much involve gradual exposure to thoughts/images of vomiting itself. Whereas treatment for you (not that I’m saying you will/should get CBT) would involve learning to cope with social situations despite anxiety. I’m not sure if any of that made sense. Also, I’m no mental health professional.

Tired Caregiver said: July 10, 201311:48 pm

One thing I found that really helped me was actually hypnosis. First understand that I’m not a big ‘alternative medicine’ person AT ALL. There’s a book called ‘Living with IBS’ that I found very useful when I was learning to control it, and it suggested hypnosis because it’s one of the few treatments that gets positive results in the majority of sufferers. So I figured I’d give it a shot (I was pretty much desperate back then) and bought a hypnosis set specific to IBS (I can provide the name if you’re interested.) One of the techniques involved picturing a mental ‘dial’ that goes from one to ten. Five is normal stomach/intestinal flow…so if I was having problems, I would picture nudging that dial up or down (depending on the ‘type’ of issue I was having) until it was at five again. I still do this years later, and it helps me feel like I have some control in a way. That in turn helps my anxiety. Because flares can absolutely be brought on by anxiety, breaking that feedback loop helps a great deal in controlling the actual symptoms.

The book also urged being upfront and telling people you’re likely to interact with often that you have IBS and a brief summary of what that means. You can do it in writing if you’re not comfortable doing it person. It takes the pressure off the ‘what are they thinking!’ aspect…my parents were absolutely convinced I had bulimia because I always ran to the bathroom after meals. IBS is one of those things that can be really embarrassing to talk about, but if you treat it just like any other medical condition, other people will tend to do the same.

The hypnosis set I have also taught basic meditation techniques, like relaxing each muscle group or doing visualizations, and again that helped me cope with the anxiety. Every now and then if things seem to be acting up I’ll go back and listen to the set again. I’ve accepted I’m always going to spend too much time thinking about what I can/can’t eat and what my stomach is up to, but I’ve gotten much better at doing things *anyway*.

Mahvelous said: July 18, 201311:59 am

I can totally relate to this! I’ve got GAD and I also suffer from IBS and this weird stomach thing that’s basically a heartburn issue. I’ve learned that the #1 thing that triggers IBS symptoms is STRESS (hard to avoid when working, completing grad school classes and internship, and trying to have a social life/time with loved ones), so much so that I ended up in the ER last year from extremely painful heartburn/acid flareup. So, I try to be really tuned in to how to keep my stress level lower (always tricky with anxiety on the sidelines). I still get flare-ups, but they tend to be manageable.

Things that really help with controlling symptoms: exercise!! I cannot emphasize this enough. I get mine by biking instead of driving, where possible; yoga and gym time. Yoga seems to help A LOT. Journaling works, too…just spewing the words out on the page when super anxious or stress (I just write it down but don’t got back and read it; it’s for catharsis, not the sake of writing). Seeing a counselor when my baseline stress level is higher than I’d like; I believe this can be super important, because they can give you options you may not have known about (e.g. coping skills, meds). It’s also nice to have some neutral validation: “You are working hard despite having these symptoms” is always nice to hear from someone who’s objective…

Watching what I eat has made a huge difference: I no longer drink ANY form of caffeine (despite waking at 5:30 for work); I rarely drink alcohol now, and no more than one drink when I do (wine or anything with sulfur = I AVOID); I cut down on animal products but also high-fiber meals (e.g. burgers are to be eaten in halves, but no huge salads, either), as well as acidic fruits such as nectarines. I also cut down on my sugar consumption and processed foods (e.g. bread, pasta); I do eat all of the above, but in moderation; I don’t eat wheat for every meal, for instance (no toast for breakfast, sandwich for lunch, pasta for dinner). I’ve tried to develop a revolving list of things I can eat and places I can eat out. (e.g. seasonal veggie risotto, stir fry, pasta with pesto tofu, curry squash soup, veggie lasagna). It helps that I use cooking as a coping method when stressed!

I’ve shared my food “rules” with my close friends and SO, and they are pretty good about respecting them. Sometimes it just sucks to plan every snack, every meal, carry meds everywhere “just in case” … I try to acknowledge it and then move on so I don’t go into rumination spiral. It helps to have something awesome to think about, so I will end my (super long) reply on a humorous note: did you know that a group of owls is known as a parliament of owls? AWESOME😀

I have panic disorder, social anxiety, and agoraphobia. (I also have bipolar disorder, which makes everything worse, and some undiagnosed digestive problem that makes travel even harder. And no, I have no health coverage.) I leave my house maybe two or three times a month on average, and I can’t do it without someone helping me. Thank goodness for the Internet, right?

I’m thinking about getting a dog to act as my safety “person” so I can leave the house a little more (and, hopefully, so I feel a little less lonely when I am at home). But a lot of my anxiety gets kicked up by perfectionism, so if I feel like I’m not effortlessly flawless, it can kick up panic attacks, and I pretty much stop functioning. I also get anxious about my mild pet allergies/asthma combination that would mean I would have to keep the space the dog as clean as possible.

Basically, what’s it like having a dog and anxiety (and agoraphobia, if anyone has it)?

K said: July 8, 20137:00 pm

I don’t have the allergy/asthma issue that you mention, but for me, having a dog around is really helpful for my anxiety. Having a dog to pet and pay attention to is a good distractor when I need to turn my thoughts away from something that’s making me anxious, and I find the presence of a loving animal very soothing in general.

But I think a lot of it depends on the person and the dog – dogs are definitely not a general cure-all for anxiety, and only you can decide if the work of caring for the dog and avoiding your allergies are worth it. Do you know anyone with a nice dog who would let you dog-sit for a weekend? Some sort of trial run might be a good idea.

Badger Rose said: July 8, 20137:05 pm

I second a trial run/dogsitting venture (if you have friends with dogs, chances are excellent they would be over the moon delighted by someone wanting to watch their dog[s] for a week while they go on vacation). And also spending plenty of time with any dog you might want to adopt. Because… I find dogs soothing. Some dogs. In some circumstances. Other dogs I find anxious-making. And I only would have known that by spending time with them. (And my own personal feelings don’t exactly match the breed stereotypes–I am peachy with German shepherds and huskies, which make a lot of people anxious, and I find standard poodles anxious-making for reasons I can’t articulate, even though they’re lovely dogs. Which is why it can be a good idea to spend time with the breeds you’re interested in, one-on-one.)

I’m agoraphobic and bi-polar and my dog saves my life. I’m actually not even sure what to say about her beyond that. Your experience could be totally different. Your dog might be totally different. But my dog is unconditional love, enthusiasm for life, curiosity and energy. (She’s a Jack Russell terrier.)

She is absolutely attuned to my mood. If I cry, she is in my lap, licking up my tears. If I’m anxious, she is at my feet, winding her way around my legs, putting her paws on my knees and trying to read my mind. She defends me furiously from the doorbell and so I have to be calmer to calm her down. She lifts the black of my worst moods, gives me a reason to get out of bed in the morning, and motivates me to get exercise and sunshine. I would probably leave my house once a week without her: with her, I leave it almost every day.

Your mileage might vary, of course, but getting her was probably the smartest decision of my life. And losing her is actually one of my biggest fears. I honestly don’t know how I would/will survive. But she is still absolutely worth it. (And I have allergies, too! I just take pills and deal with being chronically congested. Totally worth it.)

veryslowwriter said: July 9, 20134:56 pm

Dear Sarah,
I love your dog.

Tired Caregiver said: July 9, 20135:36 pm

“Your mileage might vary, of course, but getting her was probably the smartest decision of my life. And losing her is actually one of my biggest fears. I honestly don’t know how I would/will survive.”

This is one of my anxiety makers…my cat is the single most important thing in my life (yes, even over my mother.) There are MANY days when the ONLY time I smile is when I look at him. He makes everything so much better just by existing.

The thought of NOT having him in my life is so devastating I’m actually tearing up just from thinking about it. Mumford and Sons has a song lyric that pretty much sums it up…’where you invest your love, you invest your life.’ I have invested so much love into this cat that he has become my life.

This Thursday he’s actually going in for a dental/exploratory on his eye socket (he lost both eyes in kittenhood and has had MANY medical problems due to the neglect of those early weeks, so I’ve also invested a great deal of cold hard cash into him…over $28,000 and counting.) This will mark the 9th time he’s gone under the knife for one reason or another. 8 of those times he had no complications and everything went smooth, but the very first time (when he was a tiny, sick kitten and the first eye was removed) he arrested and had no heart beat for three minutes. So I’ve absolutely TERRIFIED of this procedure even though I know it has to be done. I’ve been dealing with it mostly by trying not to think about it, because every time I do I want to pick up the phone and cancel.

So in conclusion…pets can absolutely be amazing and great anxiety reducers, but in some situations they can be a huge source of it as well.

Captain Pyjamas said: July 9, 20137:28 am

I have two dogs and overall they really help. If I can’t clean the house because I CAN’T, I think, but if you don’t the dogs will find things they shouldn’t eat or fall over something, and suddenly I can do it because the dogs’ safety is far more important that my worries. When I have a panic attack they sit with me and lick my face until I’m okay again.

I would highly recommend getting a small dog that can get exercise indoors if necessary, because I sometimes get anxiety about walking the dogs (and about letting my boyfriend do it), so don’t get anything like a staffie or a husky who will go mental if they don’t go out every single day.

I do feel safer going outside with the dogs, but be aware that people will talk to you if you have a dog, and headphones aren’t really appropriate because you need to be really aware to keep the dog safe. You can always say “I’m sorry we’re in a hurry/my dog doesn’t like people” or whatever but if you don’t like people that can be an issue.

Overall: yes, if you have a backup helper who can walk the dog/go to the shop for kibble/etc and remember your dog is a living thing with its own needs (my dog has anxiety! Which helps because I know I have to stay calm to help her be calm).

Oh! And my mild allergies cleared up entirely by being exposed so much to dog fur.

psocoptera said: July 9, 201312:12 pm

If I can’t clean the house because I CAN’T, I think, but if you don’t the dogs will find things they shouldn’t eat or fall over something, and suddenly I can do it because the dogs’ safety is far more important that my worries.

My kids are a bit like this for me; before I had them I sometimes used to get “frozen” for hours or days at a time, like “whoops, I’m running late for work, I can’t go to work because I’m LATE and that’s NOT OKAY and I’ll be in trouble again but I have to but I can’t because now I’m even LATER but I HAVE TO but now the day is almost over but I CAN’T MISS WORK and now it’s night time and maybe if I just sit very still on the couch and never get up time will freeze and whatever consequence I’m scared of will never come to pass”, more or less. But now that I have quit my job and been a stay-at-home mom for the past four years, this never happens any more, because even if I fall into a freeze over something hard I’m supposed to be doing while one of the kids is taking a nap, it is always quickly shattered when the kid wakes up and needs me again. I don’t mean that it’s all warm fuzzy overflowing love all the time – I have felt lots of not-so-nice things in response to my crying children, including exhaustion, frustration, anger, despair, etc – but never ever that kind of frozen anxiety paralysis. To me, it’s sort of like my kids call to a “more primal” part of my brain that’s somehow “deeper” than all the anxiety/social approval stuff (but then, my anxiety is very much about judgment and labels and not like bodily integrity stuff, I wonder if it would work less well if my anxiety was more about physical threats rather than sense-of-self-worth stuff?).

(Should add: no formal anxiety diagnosis, but yes depression diagnosis that in retrospect I think would have been better served by exploring treatment for anxiety.)

Getting a pet is definitely something to think through, but if you want to and you can … well YMMV but my dog has literally saved my life. I have depression and general anxiety disorder and panic disorder, and getting my dog was one of the best decisions I’ve made. I liked the idea someone had above of petsitting for a friend’s dog first, because it is a lot of work (and sometimes money), and also make sure you think about what traits you want in a dog before you get one. We joke that my mutt is part cat because he’s so lazy and loves to cuddle with us on the couch, and that’s perfect for both my lifestyle and my personality. But yeah, when I’m anxious and afraid I can pet him and feel comforted. When I feel like I have nothing to live for I remember that I can’t abandon him and that gives me the motivation to push through the worst of things. When I’m too sad or anxious to leave my house, I am absolutely forced to put on clothes and walk him around the block so he doesn’t pee on my stuff. I’ll admit that now I do have some dog-related anxiety. I worry I’m not a good enough pet parent and I literally have nightmares about him running away and getting lost. But he sort of forces me to deal with life and responsibility in a much cuter, fuzzier way than anything else. I know that was a bit of a rant, but dog ownership is a pretty big part of my life so it touched a nerve. A happy nerve?

cleverhound said: July 9, 20133:25 pm

For me, my dog is also a life saver. He gives me something positive to focus on when I get into anxiety spirals. And no matter what I do, he thinks I am the most amazing person in the world, I hung the moon and stars in the sky, and I’m pretty sure he thinks I can control the weather. Sitting with the dog and focusing on him is a form of meditation that grounds me and how I find calm in the world.

But I think you have to be able to answer a few questions before you can commit to a dog:
1) Can I get the dog to a vet? For a regular visit, for an emergency, whatever. At some point, dog will require medical attention and you will feel like shit and you will have to leave the house and do it. If the answer is I’m not sure or no, then a dog is not right for you at this time.
2) Can I commit to a regular feeding and walking schedule? Again, you will feel like crap and the dog will have to go outside and pee and it might have rained and the dog is going to take an extra 20 minutes to find a spot to pee and you want to go back inside and lie down but the dog is being annoying. Can you handle that?

And I’d say make sure you aren’t putting too much pressure on your hopes for the dog. Make sure you are getting a dog because you want one, not because you think it will be a solution to your anxiety. Because if the dog doesn’t help or can’t help, or iff the dog is too much of a spazz when x or y or z happens, you are still committed to the animal.

My dog was disappointed when I started to get my anxiety under control and leave the house, because it meant I was away from him more. Heh.

I have a cat, and my previous cat did save my life. Cats are somewhat easier to take care of than dogs, but that is part of he charm of dogs for anxious folks. You can take cats out for walks, but they will not be your protector so much as the other way around… And it might be less of a walk than a sit on the porch while the cat eats grass.

Depends on what you want in a critter. I can barely remember to eat regularly, or keep a schedule, so a cat is super better for me. They free feed and they poop in a box, and then they purr for me. It is a great deal. They do seem to know when I need them and come to me, but its nothing like a dog and its connection to its person.

Delurking to post that I have anxiety/depression, and getting my first cat (I have two now) was absolutely one of the best things that ever happened to me.

Being responsible for other living creatures keeps me grounded, somehow. It’s weird… days when I can’t convince myself to get out of bed to feed myself, I can still get up to feed the cats. Partly because they will whine and complain and sit on my head until I do, granted, but also because — as someone else said about their dog — somehow thinking about caring for someone else seems to shift some of the guilt and paralysis and shame-spiral off of those tasks.

They make sure I have certain routines in my life — even if I was up late panicking about nothing at all, they still demand breakfast at the same time — which is important, because my routines around sleeping and eating and general self-care are often the first to go when my depression starts creeping in.

And at the worst times in my life, I’ve decided I had to stick around because I knew they needed me, because I couldn’t imagine abandoning them.

Besides all that, it’s somehow profoundly comforting, in some primal mammalian kind of way, just to have them around. They are very empathetic to my moods and will absolutely try to comfort me when I’m upset or anxious. Pets have a very real ability to lower stress and anxiety levels — this is why they’re used in therapy, brought to visit people in hospitals and old folks’ homes, etc.

I’m not sure if I could have a dog, what with the whole Leaving The House Is The Hardest Thing That Has Ever Happened thing I get sometimes. It’s nice that the kitties don’t have to go outside, and in fact, on some days my one cat and I feel similarly about the outside world (clearly it is big and scary and full of horrible loud noises and it’s much better to stay in here, where it’s safe). Which cracks me up, even in the midst of it. But I digress.

I also volunteer at a local animal shelter, socializing with homeless cats, which basically just means I go in for 4 hours a week and literally just pet and talk to and play with the cats and kittens waiting to be adopted. I volunteer in the back, so it involves minimal human interaction (sometimes none) and is immensely rewarding and relaxing. So I highly recommend that, too, especially if you’re not sure you can commit to having a pet of your own. The dog volunteers actually take dogs out for walks during their shifts, so that might be more work, but maybe also better because more exercise and stuff, I dunno. 🙂

DFTBAwkward said: July 10, 20135:30 pm

I have anxiety and occasional bouts of depression, and my dog has been a huge help and asset through all of that. I had a bad depressive spiral in the fall a few months after I got my dog, and I don’t know what I would have done without him. He has been such a comfort to me! He has a very goofy and loving personality, and he is always able to make me smile at least a little when I’m really, really struggling. And like others have said, it’s a motivator to get out of bed because he HAS to be fed and HAS to be walked and HAS to be played with–they keep you moving! I adore my dog and my life has been greatly improved since I’ve had him. 3 years next month!🙂

One thing that might help with anxiety is to crate train your dog and crate him when you aren’t home. That way you know he’s not getting into anything or hurting himself while you’re gone. If you are consistent in training this is NOT traumatic for your dog. My dog willingly goes in his crate when it’s time for me to go to work in the morning, and sometimes if there are a lot of people in the house or he’s stressed he goes in there on his own–it’s his little retreat, his safe space. My former roommate didn’t crate train her dog, and one day while we were both out of the house and he was loose, he ate razor blades out of the shower. Not only is crating safer for your home and belongings, it’s safer for your dog, too.

And lastly–please look into getting a dog from a shelter! There are so many out there who need the loving home you can provide. My dog is a shelter mutt but he doesn’t shed (and is thus allergy free). If you want a specific breed, there are many rescues that focus on specific types of dogs.

If you’re not in a position to keep a dog (can’t walk them, landlord only allows caged animals, not your house, etc), you might consider rats. A lot of people are squeamish at first, but pet store rats are domesticated with a capital D. They’re social like dogs are — they have sort of a pack structure, they look to you as leader, and they do things specifically to get your attention and approval. Male rats in particular tend to have the personality of a slightly dim Labrador retriever. They love you ever so slightly more than they love your sandwich. They are also tiny self-centered little attention sponges who will soak up all of the head-scratchies and tummy-rubs you can give them, and get very worried when you have the flu, on account of if you die then who will fill their food bowl?

They’re also very cheap to keep. After you’ve bought the cage and water bottles and food bowls, they’re very nearly free. They do quite well on a mix of uncooked pasta (to wear their teeth down) and oatmeal, supplemented by table scraps. Pet store bedding and accessories can get expensive, but they’re just as happy sleeping on shredded newspaper and advertising circulars stuffed into discarded cardboard boxes — happier, even, because they can chew new windows into their cardboard house wherever they want.

I keep them around for cuddles, and because if there’s one thing I can always succeed at no matter how crap my day has been, it’s pleasing my tiny rodenty masters. All I have to do is stick half a banana in to the rat cage and I can go to bed knowing I made SOMEONE happy.

One of mine has decided his favorite thing in the world right now is inexplicably broccoli. There is no fathoming the mind of rat.

MJ said: July 8, 20136:45 pm

Big shout out to Dialectical Behavior Therapy. It teaches coping skills for when emotions get too big and extreme. For me, one of the most helpful ones is to just pay attention to my body. When I start to panic, for example, I narrate it: “My heart is beating fast and hard. My chest feels tight, and I’m out of breath. My head is spinning. I feel hot, but my fingers and toes feel cold.” Those feelings are all really intense, so it’s easy to give them my full attention – it distracts me from whatever was the stimulus for the panic attack.

Also, big shout out to 50 mg of Prozac, daily. Medication isn’t for everyone, but it did me a world of good.

keelyellenmarie said: July 9, 20134:58 am

Yay DBT! (and mindfulness-related practices/therapies in general!) Done more for my anxiety than my meds have! (The meds do keep me from not wanting to get out of bed because fuck life though, so not knocking them exactly)

You know, I’ve found DBT to have limited applications for my anxiety, but I have loved it for my depression. I’m not sure why that is. I think that it’s because when I panic, doing the mindfullness things make me focus more on my body which reminds me of the panic, which makes me panic more lol. But it’s been really helpful for keeping me from letting small issues become big spells of depression.

keelyellenmarie said: July 9, 20133:20 pm

Yea, mindfulness can be a double edged sword that way. I find that it’s more helpful as a tool to keep the general buzz of anxiety down, but when I’m full-on-panicking there are certain techniques (like focusing on my breath, ugh) that I won’t use because they’re counterproductive in that case.

Yeah, when I’m having a panic attack anything that reminds me of my body or my physical existence will make me nauseous and more panicky.

MamaCheshire said: July 9, 20138:56 pm

DBT isn’t everyone’s cup of tea, nor does it have to be. In my corner of the world it seems to be the shiny new hammer that makes everyone’s problems into nails, and that bothers me, because people who don’t find it helpful get the “YOU AREN’T TRYING THEREFORE YOU SUCK!” thrown at them, and NO.

I think it is a decent option (but still shouldn’t be considered the only option) for the stuff it was designed for originally, particularly active self-harm. But in the experience of friends (including Spouse) who have tried to use it to deal with “passive self-harm”/”failure to Adult properly” issues, it’s ranged from “meh, kind of unhelpful” to outright counterproductive. YMMV of course.

keelyellenmarie said: July 11, 20133:44 am

While I have self-harmed a few times in the past, it’s never been my major issue–the pain of upsetting other people with my self-harm is usually enough to make me stop relatively quickly. Where DBT helped me was more with my anxiety and perfectionism. I needed practice and guidance on both believing that I was an okay person deserving of love and help and ALSO believing that I had a lot of problems and needed to fix them. Finding a balance between pushing myself to improve and pushing too hard/hating myself for failing has always been really hard for me, and it was in DBT that I started developing tools to deal with that. Mind you, I still struggle with that balance, but I deal with it better now, if that makes any sense.

This is not to argue with your larger point though, that DBT isn’t for everyone. It most certainly isn’t. I think there are concepts in/aspects of DBT that are pretty broadly applicable (mindfulness-based practices, particularly), but as a program of therapy it has strengths and weaknesses just like any other. It happened to fit my brain despite the fact that I wasn’t necessarily the original target audience, and I’m glad for that, but I know that other people thrive on different things.

I can totally see how CBT and DBT help a lot of people, but for me, there was a point where I just hit things that I do not have the ability to change. (My “real” panic hits so fast that by the time I’m aware of having thought anything, I’m already aware that it’s irrational/out of proportion to the thing that set me off, and it doesn’t matter because I’m also already at Defcon 5. I also talk myself out of panic attacks way more than I talk myself into them — I gather for many people, it’s the reverse.) I’ve tried formal CBT/DBT at various times and found that it made me much worse, because the dominant narrative is “if you can’t change your thinking, you’re not trying hard enough”. I perceive it as an external stressor, and it just serves to make me worse.

Has anyone else done this? Has anyone else had any success trying to explain it to a therapist? I keep trying, and it seems like a lot of them assume “can’t” means “terribly scary and I need encouragement to try” rather than actually CAN’T.

I had that with CBT too – my solution was that my therapist and I did a bit of CBT and a bit of a more psychodynamic approach. Maybe talk to therapists in advance about not focusing simply on one approach?

tbqh, mostly what I want a therapist for is so someone will tell me when I’m NOT being stupid. One of the side effects of training myself to just ignore most of the anxiety symptoms is that sometimes I ignore them when it’s NOT alarm bells going off for no reason. I’ve gotten better, but I’m not perfect. Having a therapist sit there and tell me that my anxiety is all out of proportion to what’s actually going on is rather ‘no shit, Sherlock, why do you think I’ve got medication?’ and getting into ‘why don’t you change the way you think about X?’/’I did, it didn’t make me stop freaking out’ is a discussion that Does Not Help.

I psychoanalyze myself an awful lot. I’ve tried to get into that with a couple of counselors and was basically told that I’ve already figured out the major therapy techniques for myself. and pretty much all they’d be doing is making ‘yeah, listening’ noises. I have friends for that. I have also run into a couple of them, both psychiatrists rather than psychologists, who seemed to take umbrage to the fact that I already knew what was going on in my head and could describe it using long medical words. I really hope that was an anomaly.

MamaCheshire said: July 11, 20135:19 pm

I’ve tried formal CBT/DBT at various times and found that it made me much worse, because the dominant narrative is “if you can’t change your thinking, you’re not trying hard enough”. I perceive it as an external stressor, and it just serves to make me worse.

You’re welcome. It took me ages to figure out that was what it was. Something similar happens when people (with excellent intentions!) respond to an explanation of depression/anxiety with, “OMG, did you try [random thing I read about on the internet]?” I realize they’re trying to help, and that sometimes it comes out wrong because they suspect they can’t do anything and it makes them all flail-y, but it still feels like they’re implying that I’m still in a hole because I haven’t taken charge and done the impossible.

Allie at Hyperbole And A Half likens this tactic to an armless person punching themselves until their hands grow back. I quite agree.

MamaCheshire said: July 11, 20135:26 pm

Oh! And to answer your question, sort of, about “can’t” actually MEANING “can’t” – if the therapist is doing strict by-the-book CBT or DBT and is being all One True Way about it, then probably not. If the therapist can be moved from that at all and stop playing Behavioral Buzzword Bingo, what Spouse and I have found helpful, instead of “can’t”, is, “If I attempt X, then A, B, and C will happen. I know because this has happened more than once – [describe situation if therapist will listen, which zie should because it’s zir gorram JOB to listen!]” or, “If I do X, there is an unacceptable risk of Y. Y would be detrimental to my life in Z way. Can you help me with either reducing the risk of Y or how detrimental Y would be to my life?”

Hi there, kinda late to this party but still useful hopefully. Have you heard of ACT? It’s Acceptance and Commitment Therapy – basically revolving around the idea that it’s very difficult (and perhaps impossible?) to change the anxiety itself, but you can change your relationship with it by accepting it (sitting with feelings, letting them pass over you like clouds across the sky) and focusing instead on your personal values and creating the life you want and committing to certain actions etc. Basically, limiting anxiety’s impact on your life choices. I found it was far better for me to try relational change with anxiety than trying to change the anxiety itself. Just another option! Good luck!

That’s basically what I worked out for myself years ago. Part of it is that there’s oogly-boogly dynamics in my family that made it actively dangerous to admit to freaking out when I was around them, so I learned to DO things that belied no anxiety even if I was dying inside. Mostly it’s just that I’m exceedingly stubborn with a streak of pragmatism. I never liked the paradigm where you’re supposed to look upon anxiety and/or depression as some ‘other’ thing sitting in your brain, fighting against the ‘real’ you. All of this is part of my own brain and always has been — it’s always been there, and it’s always going to be there. Way to set me up for a war I can by definition never win! Surely, continual guaranteed failure will help me cope with life!

Cynicism aside, I’ve found it’s a lot less effort to outwit myself than to simply go on trying to punch my jerkbrain until my metaphorical arms fall off. You know that thing people say about how when all you have is a hammer, everything looks like a nail? What I have is a very big brain. Brains are much too squishy to use directly in driving nails, but they’re excellent for finding other things that can be employed as a hammer. One of the most useful things I ever did was turn a persistent case of hypervigilance into a skill instead of a liability. I somehow — and don’t ask me how, because I don’t actually know — convinced myself that noticing details all the time didn’t mean my brain had flagged something as scary, it just meant my brain had flagged something as interesting. It’s of near-infinite uses when I do social psych.

I don’t know if I have an actual anxiety disorder, but I know that sometimes the thought that I might have missed something very important makes me feel all nervously queasy, and what with everything I’ve got going on right now (moving countries/into a new place/starting a new job), I’ve got tons and tons that making feel squiggly. I worry that I will fall off my bicycle and into the road and get my head smashed like a watermelon by a passing car. I worry about the fact that my housemates only lock the doorknob, and the fact that I came home from work today and the door wasn’t completely closed, and I worry about the fact that my bedroom door doesn’t have a lock on it. I worry that my stuff will get stolen or damaged because I can’t adequately protect it. I worry that living on my own wouldn’t really fix anything, because then I would be worried about the same things and other things and then I would be by myself and not have anyone to talk to about the things that worry me. And the worst of it is, I’m not sure who I should talk to about it. I still have to do a ton of stuff with HR to find out if therapy is an option and how, and even though I’ve lived in this town before, I feel like I don’t know terribly many people here, so I’m just trying to call my parents or people I used to know from Europe, which causes Time Difference Difficulties. I can tell I’m getting a bit worked up, but this was just what I needed to see, and I’m not great about talking about it.

Psychologically speaking, a disorder is a disorder when it becomes intrusive enough to displease you. If it’s interfering in your life, then it is by definition “bad enough” to ask for help. That’s the thing with psych stuff — it’s not a matter of putting up with the “symptoms” of something because the underlying “disease” isn’t severe enough to warrant medical treatment, the “symptoms” and the “disease” are essentially the same thing. Wanting to do something about it is sufficient reason for seeking treatment.

My anxiety and my depression fed off each other, and I use the past tense because since I started taking my meds (paroxetine) my anxiety is mostly under control. By under control I mean that I’ve had 3 anxious spiral-out-of-control episodes in the last 8 years, and in each case there was a major life event preceding it, and each one lasted less than 48 hours.

Other things that have helped are treating my mental illness as a chronic condition, or disability, which means doing things like counting my spoons, and avoiding situations which are too tiring. It also means feeding myself, because my anxiety was often linked to days when I hadn’t eaten enough, and was running on empty. (This often resulted in a feedback loop of being too stressed to eat, or having a minor freak out because I couldn’t get the one food that I thought I might be able to eat.)

This also means managing my social life more, and not leaving so much up to chance. I go to less parties and gigs than I used to, but I spend more one on one time in comfortable settings – i.e. not much background noise of bustle. When I do go out to a bigger event, I give myself permission to leave at any time, and I usually arrange to arrive and leave by myself, so my desire to leave doesn’t impact anyone else. I also give myself permission to stay home for any reason, no matter how silly it would seem to someone who’s not me.

I also do a fair bit of my socializing online, which includes social media, blogging on dreamwidth, and IM. That means I can stay in touch with people who matter, and have silly jokey interactions with them, without having to think about the background environment at all.

I love self-serve checkouts at supermarkets for those days when I have burned out on human interaction at work, and just want to get home, eat, cuddle cats, and relax.

I’m single now, but in my last relationship I was very upfront about my mental health stuff before we got to the commitment stage, so when it showed up, my partner wasn’t completely taken by surprise.

Oh, and this is longer ago, but one of the best things I did to manage my anxiety was to quit smoking. That cycle of stimulant and craving was definitely contributing to my anxiety levels, and what helped me quit was reading articles about how nicotine triggered stress and anxiety and realizing it was something that would be immediately affected by quitting, rather than maybe some health issue that might arise years from now. Less people seem to smoke these days than in the 90s, but if you do and you are reading this thread, it may be worth searching for articles on links between nicotine and anxiety. (On a day when you are feeling up to it.)

LifeIsConfusing said: July 9, 201312:30 am

(Moderation note: I don’t know if this comment is considered close enough to anxiety disorders and isn’t very well planned out, so I apologize if you spend time dealing with it you’d otherwise prefer to be juggling beach balls. I figured I’d try to post here since I’ve been following CA for way too long and way too obsessively to be this anxious about saying anything, and I saw this thread and knew it was for me. I totally understand if this isn’t the time, though.)

(Content warnings: anxiety, depression, eating disorders.)

I can very much relate to anxiety and depression feeding off each other. Depression Jerkbrain getting mad at Anxiety Jerkbrain and then getting mad at itself and the rest is history. Spoons are totally useful, unless it is one of those bad days you get anxious about miscounting the number of spoons you have and/or getting stranded somewhere without any spoons. Or Depression Jerkbrain nosediving and half your spoons sinking somewhere off the coast of Greenland. Or maybe that’s just me.

Also, here is something I’ve been running into recently that I’m wondering if others have experienced. I’ve been trying to take care of myself better, ’cause Depression Jerkbrain apparently really likes just having me sit there and not be able to sleep or spend hours wanting to cry but not being able to. I also realized and discussed with my (once and future) therapist some potentially-EDNOS-like stuff going on, mostly binging and then feeling terrible and getting attacked by the Jerkbrains. So we decided that part of taking care of myself would be to try to avoid binging, which… has resulted in my not eating enough. So now Anxious Jerkbrain is getting terrified because I’m losing weight and Depression Jerkbrain is trying to blame it on me and everything is so meta it hurts.

Also, can I just say that I find it weird that I can simultaneously be scared of asking people for more help because they will think I am boring, scared that telling people how messed up my life still is will hurt them, scared that I am not admitting to myself how messed up it is, and scared that I’m not getting enough help? How does that even make sense?

Like I said above, and also in the thread about taking meds, for me anxiety and eating are/were very intertwined.

I have friends who when they feel anxiety building have learned to eat something bland with protein (nuts, yogurt) and digestion actually helps head of the adrenaline surge somehow.

I don’t know if this will be helpful, or if it will conflict with advice from your therapist, but I’ve been reading The Fat Nutritionist for the last few years and Michelle’s blog has really helped me deal with a lot of the emotional issues I have surrounding food. Like Captain Awkward, it is a place where it is safe to read the comments.

If you read her and find it useful, you might even direct your therapist to her site so that you can discuss some of the ideas together.

Depression is weirdly ego-centric and ego-dystonic at the same time. You simultaneously feel invisible and like you’re the biggest problem in everyone’s life. IME, it takes a surprising amount of energy to cope with people trying to help, particularly when they’re the kind of people who mean well but execute rather poorly. It’s virtually impossible to tell someone you’re depressed and have them not try to do SOMETHING, so you try to manage the amount of freaking out that other people do AT you by not telling them when things are wrong. Vowing to keep your mouth shut intensifies the feeling that you’re invisible. The less you tell people about anything the more they think you’re pulling away, and generally they figure that means something wrong, so they give chase; the more they do that, the more you feel like a horrible inconvenience.

It’s a rather nasty circle which many people, including me, cope with by developing Oscar-level acting skills. I should have a shelf full of Academy Awards for the amount of time I’ve spent successfully convincing people I’m perfectly all right.

TheWanderer said: July 8, 20136:53 pm

I have mild anxiety, thankfully it hasn’t paralyzed me but I’ve had to fight against it non-stop for years. Like songofmyself, I grew up in a household where mistakes were not tolerated very well and shame was high. Everything from getting on a plane to going to a big event to meeting new people makes me a little anxious, and sometimes I will subconsciously sabotage plans to do new, anxious-making things by getting lazy / tired / being too late / not packing properly.

I have used the “control-everything” approach and it helps with some things – I live on my own and can control my life pretty well – but not with others (I can’t control my lovely partner… but when something’s wrong in her life I have a really strong desire to find a way to fix it or, failing that, to run away; this has been the story with all my previous relationships). Similarly, I can’t control my friends, my family, my coworkers, etc.

These days, I am more into openly admitting that something is making me anxious, and taking small steps. I have to go to conferences a lot for work, but now I will try to just meet a couple people and retire instead of forcing myself to work through anxiety and talk to as many people as possible. At the same time, I admit that my anxious feelings are not helpful, and I try to be helpful. If my partner has had a rough day at work, and I have the spoons to help her, I can say something like, “I’m feeling anxious right now, but I understand that that sucks, and do you want a hug?” instead of being like, “well if you just did X and Y and Z clearly that would solve all your problems.”

Another coping mechanism I’ve learned is social graces. It sounds super cliché, but being polite, having harmless general topics to discuss, excusing oneself from conversation are so helpful at avoiding those awkward pauses that make me super anxious because clearly I should be coming up with something witty right now.

I don’t know to what extent this is helpful, but I wanted to share. Oh, and for the record, I also want to go to an Awkwardeer meetup, they sound fun – but I am also anxious. What if there are complete strangers? Or… what if there are friends there, and then somehow that’s also awkward? Halp!

“Oh, and for the record, I also want to go to an Awkwardeer meetup, they sound fun – but I am also anxious. What if there are complete strangers? Or… what if there are friends there, and then somehow that’s also awkward? Halp!”

I organise the London one, and I have had several people email me ahead of time to check something or ask follow-up questions. I have always been happy to help with this. I can’t speak for the other organisers, but I think it’s highly likely that they would feel the same way.

One of the benefits of CA as a community is that we have a higher-than-average awareness of this stuff, and are motivated to try to do better. Doesn’t mean we’re perfect, but does mean that we’ll try, especially when we know that there’s something to be aware of.

So my suggestion to you would be to email the organiser of a meetup you’re thinking of attending, and ask your questions. It’ll give you more information to decide if it’s right for you, and it’ll give you a head-start on knowing one of the people there.

(If you’re in London, meetup is this weekend! Anyone interested in coming should drop me a line at kate DOT towner AT gmail DOT com)

Number one thing: Being late, when you don’t actually have to be late and then saying “well, I’m too late” so not going somewhere.

When things aren’t so bad, I use lateness as a bargain with myself. Like, “Well, you have to go to this thing, but I’ll let you be late.”

It’s nice (? word choice) to know that someone else is doing the same thing. I’ve tried explaining it to people and it makes zero sense to them, but to my brain it’s a totally workable solution to a bigger problem.

When I’m at my best, I don’t use lateness as the bargain. I use time. Like, I’ll say to myself, “Well, you have to go to this thing. Be on time. But, hey, if you feel overwhelmed, let yourself take a minute. You deserve it.”

rr said: July 8, 20137:06 pm

Hi! I have anxiety and hope to soon sstart some CBT treatment for it, so we’ll see how it goes. For now, I’m dealing with it through the magic of plan making and also using my depression for the forces of good. For the plan making, I try to follow down the anxiety path: oh noes what if the street floods! Okay, so here’s an alternate route to get around the flooded area. What if, what if, what if, and then plan around it. I have lots of lists and some very well-organized spreadsheets. I’m planning on moving states in a few months and I’m hoping the magic of making all the plans will make the move much less horrilbe than it woudl otherwise be.

As for the depression, one of my anxiety things is that people are mocking things I say (I’m not good at expressing myself verbally extemporaneously; if I have a moment, I’m pretty good, but in casual conversation, I’m much more comfortable if I trust someone to wait out my stammer). But the depression reminds me that no one cares about me and that no one remembers me and no one is paying any attention! So it cancels out, I could embarrass myself, but people are self-absorbed with their own problems or aren’t paying full attention, and even if they are, they’ll forget the details of what we talked about and only remember the general points. And people are too busy to mock me with their friends, because people have lives that don’t involve me. Barriers magically lowered!

Haha, yay depression? That reminds me of something (much happier and less depression-related) that I’ve used to talk myself out of anxiety about strangers and new people judging me. I realized that my whole life I’ve assumed that people are judging me harshly, but I just about never do that to other people. I mean, I will think “that person did x, which is shitty and cruel, and I am judging her for it.” But I never think “Oh. My. God. Did she really wear that? Why is she talking funny? She is emphasizing the wrong syllable and talking to fast and I AM JUDGING HER.” So I realized that if I don’t go around analyzing every aspect of someone’s conduct for things to be mean about, most likely no one else does either.

cleverhound said: July 9, 20133:34 pm

Oh totally. I do that too. I’ll think “I’m worried about person thinking (thing). Is that a thing that people would actually say? Probably no, and if they did, then they are really an asshole and I don’t care what they think of me/are not worthy of my time.” It can be helpful when I’m anxious about something. “The odds of that person thinking back to that interaction and going, hey, that was the most awkward conversation of my life, are…very small.”

You kind of have to be careful how far you let the planning thing go, I’ve found. If you don’t keep an eye on it, you might find yourself planning for plan failure, and then planning for the failure of the fallback failure-plan, and then planning for the failure of the… until you find that going out to get groceries involves working up a defense against a nuclear first-strike from Canada.

Badger Rose said: July 8, 20137:18 pm

One other thing that has been super, super useful to me:

Realizing that the jerkbrain is a bully.

My jerkbrain and my anxiety are not the same thing, but my jerkbrain tends to co-opt my anxiety.

If my anxiety says, “OMG, it’s terrifying to do X,” my jerkbrain says, “…because if you try to do X, you will fuck it up, or make other people uncomfortable, or otherwise FAIL.”

If my anxiety says, “OMG, it’s been a week since you did Y chore,” my jerkbrain says, “…because you suck, and even if you do it now, you can’t fix it, because you already blew it by waiting so long.”

If my anxiety says, “OMG, Z must be mad at you, because he emailed you/didn’t email you/looked at you/didn’t look at you/flicked his eyelash in a weird way,” my jerkbrain says “…and he is mad at you because you are terrible person and you suck and you should feel bad.”

The most important thing I learned about my anxiety:

– My anxiety is not always right.

– My jerkbrain is a bully, and I do not need to obey it, EVER.

The former is useful because it means that I can question things–like, “is there an actual reason that the grocery store clerk would be mad at me? …no? Then maybe… I don’t need to be worried that they’ll hate me.”

The latter is useful because it means that I can go, “I am not a bad person. Even IF, contrary to all likelihood, the grocery store clerk is annoyed… I am still not a bad person.”

The jerkbrain, in short, is a bully. It’s a bully who takes personal information and uses it as a weapon. It’s a bully who knocks you over and then hits you when you’re down. It’s a bully who doesn’t play fair, and who picks on your weaknesses.

And you do not ever, ever, EVER have to bow down to bullies. Even to the ones inside your own head. EVER.

Badger Rose said: July 8, 20137:22 pm

(It was actually really useful, for me, to envision a Champion who is the opposite counterpart to the Jerkbrain. The Jerkbrain is the worst and most self-destructive part of me, who plays dirty and tries to hurt me on purpose, without my permission, and for funsies. The Champion is the best and most self-building part of me, who plays fair and tries to protect and improve me, with my permission. My Champion is a winged Athena whose sword is ready to clobber the Jerkbrain… as long as I remember to ask, because the Champion, unlike the Jerkbrain, can’t act without my consent.

I am now going to go hide in a corner over how embarrassing it is to admit that. But. It’s helped me a lot, and I hope it can help someone else.)

JenniferP said: July 8, 20137:23 pm

I love these images so much!

Remy said: July 8, 20137:38 pm

My Jerkbrain gets ignored if it’s mean, while I comfort/soothe/reassure myself the way I would my favorite cat who got spooked by something trivial. (“It’s okay, silly kitty.” *pet pet hug*) Takes a lot of the sting out of whatever Jerkbrain found it necessary to comment on.

See, I used to have this really common anxiety dream. I started to describe it and then realized that it’s more likely to be triggering than useful. But once I dreamed that these three gigantic trees with their root balls protected came up on flatbed trucks and basically steered me away from danger. And ever since then if I can get my dreams to the point where I can find one of my trees (birch and ash and spruce–they’re not my favorites, they’re the ones that are mine, if that distinction makes any sense), I can get it to be not an anxiety dream.

So I have started focusing on the feel of one of those kinds of bark under my fingers when I notice my brain being a jerk or otherwise steering me anxiously. Because trees are just kind of there. Doing their tree thing. I love them but am not in charge of them. If that makes sense. They sort of overwhelm other stuff, like noise is better in a forest. Also I am not very visual, so for me the image of a tree is not the important thing to prompt my brain to be doing.

I was about to include a disclaimer about how weird this probably sounds. Then I thought, wait, Badger Rose didn’t sound weird to me at all, even though hers is not at all like mine.

That sounds really lovely to me. I am going to try to think about trees the next time I’m stressing.

Not It said: July 8, 201310:26 pm

I do these relaxation techniques occasionally and one of them directs you to imagine yourself as a tree. I think you would like it. The narrator takes you through turning your feet/legs into roots that are grounded and then your head/arms reach up to the sun for nourishment. You draw energy from the environment.

See that happens to me alot. Especially at work if I start feeling anxious because I did something wrong, or forgot something or if I even just think I did something wrong, the logical part of my brain says “its ok, you didnt mean to. You tried and failed but it doesnt make you a failure.” But jerkbrain decides to keep me in that stressed out level yelling at me telling me I failed because I am stupid and because I didnt try hard enough. Often the visions are like a little me and a big me, the big me always being the dominant jerkbrain. I guess I never really thought of it as a bully, but now it makes sense.

My way of trying to fight through that internal battle is, lately I have been watching Joel Osteen alot. I grew up in the christian faith (though not in a christian household per se if it makes sense). Watching and listening to Pastor Osteen has helped me in a way my faith never has before. I cant say his positive talks have always helped completely (lately despite watching him I have kinda hit near rock bottom), but it has at the very least helped me feel not as worthless or hopeless.
I am not trying to push religion here and maybe its a little silly to some, but thinking about having a higher deity that may be looking out for me at the very least gets me through the day.

keelyellenmarie said: July 9, 20135:05 am

That is so, so lovely.

gmg said: July 9, 20134:46 pm

I feel like my jerkbrain is less of a bully and more of a … I don’t know how to describe it, really, but kind of like a hectoring parent who never lets up. I seriously, when I am having a work-from-home day or am otherwise alone in my apt, have a running Jerkbrain monologue that often is actually enacted OUT LOUD: (“COME ON gmg, why the HELL can’t you stop procrastinating and get this stuff done, what the HELL is the matter with you, COME ON etc etc etc.”) Maybe I need to come to the realization that “hectoring parent who never lets up” and “bully” are synonyms …

My jerkbrain also has an unfortunate friend, Angry Girl, who helps keep my anxiety level way higher than it needs to be when she goes off on internal (and sometimes, eek, external, see above) rants about stuff that is pissing her off. She actually has arguments with Jerkbrain. (Angry Girl, earlier today: “GRAHHHHH this crappily written thing I have to fix is SO CRAPPILY WRITTEN GRAAAHHHH and even though I am an editor and this is my job it’s PISSING ME OFF.” Jerkbrain, dripping with contempt: “STOP IT, gmg, just STOP IT RIGHT NOW.” And so on.)

OK, so I sound more unhinged here than I really (usually) am, honest. But the plain truth is that my inner-and-sometimes-outer monologue is most often NOT NICE TO ME (or, frankly, to others), and that needs to change, and I much appreciate the suggestions in this thread and from the Awkward Army in general as to how to do that.

Ahh, Captain, thank you for this thread! I have not been diagnosed with any kind of anxiety disorder, but I am in therapy for childhood trauma stuff and also working on anxiety stuff. Weirdly, I had never thought of my many fears and roadblocks to doing stuff as anxiety before my therapist called them that. Recently I’ve been wondering if maybe that’s because I’ve been living with some anxiety for my whole life. Sometimes I feel like I can handle things pretty well, but other times I feel paralyzed by the anxiety. I have noticed it is getting a lot worse since I haven’t been socializing a lot and just moved to a new place and am feeling very anxious about getting a job and making friends. It feels like I spend a lot of energy talking myself down from the anxiety and then don’t have any left for what I need to do. I am now considering trying to get some kind of diagnosis and some medication for it even though I’m not sure how much of it is brain chemistry and how much is situational.

So I wanted to ask those of you who do use medication if maybe you could share a little of your experience with it (as some people have done above). I.e. things like: What made you get diagnosed/decide to use medication? What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)? Do you like it?

meh said: July 8, 20137:43 pm

I recognized my diagnosis myself in middle school, and brought myself under control without drugs or telling anyone. It was not easy and remained a continuing struggle. I sought treatment in college, because I had recently been through a national disaster and I needed all my energy for dealing with people trying to recover.

First drug: Anti-depressant. Made me horribly nauseated for a week and a half. I could eat no more than three bites at a time and had to carry the two foods I could swallow with me so I could eat three more bites every hour or so. Once the nausea subsided, I found I could be happy again. I hadn’t noticed that I wasn’t happy (aside from the disaster thing) and was probably not medically depressed, but I was enough so that I was….very bubbly with relief.

This drug also made me see horrible things when I went to bed at night, in the pre-dream state. I put this down to the disaster thing, until the doctor upped the dose and changed the time of day I took it, at which point it made me think horrible things awake, and at one point had me casually considering stabbing myself in the eye, not because I wanted to hurt myself just in a very creepily calm way. I flipped out, called the doctor and immediately went to stay with a friend explaining why I needed observation. The doctor did not take me seriously, and I went off meds without her help. That made me very dizzy for random intervals.

Second drug, anti-anxiety, tried by a doctor who talked me off of my extreme suspicion of all medication following the first drug. It makes me hot for about a half hour after I take it, and very slightly disoriented for the same half hour. I take it before going to bed and an hour before getting up so that these two slightly unpleasant symptoms happen while I’m asleep. I have been on this medication for 10 years. It doesn’t address my illness directly, but addresses the anxiety that drives it, so symptoms are reduced. I sleep better at night, I began being able to just go to bed and go to sleep for the first time in my life on this medication, and I need less sleep because it improves my sleep quality, not being so anxious. I became able to focus better to a significant degree. I began to be able to go to social gatherings where I only knew a few people, and while I didn’t love them, I could sit through them and have some fun. Pretty much everything is better, and I was shocked to find all the things about me that I had thought were traits of me (hating parties, having trouble concentrating, having trouble getting to sleep) that turned out to just be one more symptom of the anxiety that disappeared.

In conclusion: drugs can be super unpleasant and have terrifying side effects. Drugs can also make life so much better it’s hard to believe. A lot of it is the doctor and being willing to sit through trying them, and being willing to cast a bad doctor aside.

Marwen said: July 8, 20138:31 pm

“What made you get diagnosed/decide to use medication?”

My risk of dying if I didn’t was very steadily increasing. This is because my anxiety and my PTSD are comorbid and all wrapped around my depression, and reinforce and recapitulate it, and my depression comes with desires to suicide. It got to the point where no possible reaction short of immediate death could be worse than what I was already surviving every day, so I figured fuck it. (And still cried and shook and was nearly non-verbal through all my various steps of getting to my current meds.)

“What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)?”

My meds are an SSRI and DPI (escitalopram and bupropion), and I use them to function daily; the use of SSRIs in anti-anxiety medication is to lessen anxiety overall, rather than to treat specific incidents.

“Do you like it?”

I like it more than being unmedicated!

SSRIs give me a dry mouth, vivid dreams, slight lethargy, and are a pain in the ass to get onto or off of (I was on paroxetine before escitalopram). Getting onto them I have intense nausea and sleep side-effects. I get intermittent vertigo.

Badger Rose said: July 8, 20138:38 pm

I’m temporarily not using medication, but I have in the past and intend to in the future.

What made you get diagnosed/decide to use medication?

I felt awful and was having trouble functioning (panic and anxiety were interfering with my ability to do things like “go to work” and “feed myself” and “get out of bed”). My doctor suggested a combination of medication and therapy, and I agreed to it.

What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)?

I had both daily medications and emergency medications.

The daily medications basically functioned to… hm, how to put this. To lower my anxiety threshold? So let’s say that, on a scale of 1-10, I become debilitated by anxiety at 7, have a full-fledged panic attack at 8, and become utterly nonfunctional at 9. And let’s say that my normal anxiety level is 5, so it only takes two “notches” up the stress scale to tip me over into debilitated, and only three to give me a panic attack. My daily medication dropped my normal anxiety level from 5 to, oh, 3. I could still feel a full range of emotions. I could still have a panic attack, even, given sufficient stressors. But instead of two “notches” of stress to push me over the edge, it now took four.

The emergency medication was for situations where I was pushed over into a panic attack anyway–it would blunt the effects of the attack and allow me to remain functional.

Do you like it?

Yes. I’m really eager to go back on it. The ability of medication to ramp down my default anxiety level from ‘quite close to freakout’ to ‘not really that close to freakout at all’ made a huge difference in my quality of life, and I”m looking forward to getting that back.

H.Regalis said: July 8, 201311:33 pm

I have depression, generalized anxiety, and social anxiety.

What made me get on meds: being so depressed that I knew I would not live through another winter without making major changes in my life.

Part of this was just depression, and part of it was the massive amout of stress and anxiety from just trying to function. I had no close friends, no family who could help even if I had been able to ask them, nobody except this alcoholic I was dating who had a professinal background in counseling prior to their own downward spiral. I can’t say that person treated me super well all the time, but they did save my life. Outside of them though, I was alone all the time, lived alone in a shitty neighborood I hated, was afraid to talk on the phone, and walking around outside in the daytime was so stressful I would get dizzy and feel like I was going to pass out.

How I use meds: I take Wellbutrin and Celexa, 1x/day of each. Taking these doesn’t make everything go away–I still get anxious and I still get depressed, but I’m not suicidal and I can function more or less normally the majority of the time.

Prior to being on meds, I wasn’t quite a pharmacological calvinist, but I was definitely in the camp of, “Meds are fine if you really **need** them but I don’t (and would never take them myself).”

When things were really bad, I remember parking in this parking garage near my work and standing on the top floor considering whether or not the building was tall enough where I would die instantly if I jumped. A couple of years after I had gotten on meds and had my shit more or less together, a lady did actually kill herself in just that way at that same parking garage. I felt horrible for her and it turned my blood cold thinking how close that was to being me.

J. Preposterice said: July 8, 201311:39 pm

“What made you get diagnosed/decide to use medication?”

I got diagnosed because I found myself sitting in my office at work shaking and crying, and it was one thing to be a grumpy Gus at home but unprofessionalism is something up with which I would not put.

I agreed to use medication because I really, really, really needed to be able to get through a workday while remaining in control of myself. I agreed to therapy (CBT) for the same reason.

“What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)?” Do you like it?”

I started off just on Klonopin, which is short-acting & can be taken on a daily basis or as-needed (or both). I liked Klonopin a lot; for me, it would totally shut down anxiety, like a door closing, or silence descending. But then we wanted to have kids, and Klonopin can cause limb deformities, so my doc switched me to Atarax (which is a safe, doddering old medication, especially at the low dosage I take). I take Atarax as-needed, and occasionally a double-dose to shut my brain up so I can sleep; it is prescribed to me this way so yes, I’m sure that doubling up is ok! I can describe the major difference between Klonopin and Atarax thusly: on Klonopin I *couldn’t* be anxious; all I could feel was mild interest, at most, in the Worrisome Thing. On Atarax, I can feel the anxiety wishing it could happen; I can feel myself TRYING to be anxious and failing. Like with Klonopin you put your anxiety-dog in a crate with a rawhide and it just sits there chillin’ out, but with Atarax your anxiety-dog is TRYING TO GET OUT OF THE CRATE OMG LET ME OUT, GUY, I–I AM JUST TRYING TO PROTECT YOU. But Atarax is a good crate and your anxiety-dog will have a hard time getting out, even though you can hear it clattering around in there.

THEN, haha, last year my brain decided to REALLY mess with me and throw up some OCD issues and other nonsense and it was a BAD SCENE and I was all “wtf no”. So now I am also on escitalopram. I tried some other drug before that (don’t remember what, now, would have to look it up in my records), and had a BAD reaction, like, scary bad, like my mom doing a worried intervention because I was acting so out of character and frightening her bad — for whatever reason, I got really aggressive and irritable. This is a side effect that totally happens to some people with SSRIs. It is not common (I was the first case my psychiatrist had ever had, and he’s been practicing a long while), but it IS something to pay attention to, because it is a NOT GOOD side effect and can be a sign of serotonin syndrome (which can be fatal). So. That happened! We took me off that drug, and then after a break, started me on the escitalopram, with a very, VERY slow ramp-up. A common ramp-up is half-doses for a week or two, then full doses — we did quarter-doses for two weeks, then half-doses, then three-quarters, then alternating three-quarter days and whole days…. it took a long time. It was at least partially that slow to help manage my fear about the bad reaction from the previous med, and not for physical reasons. (That is one thing I like about my psych. He knew I was scared, and worked with me to find a schedule that would let me feel in control and like I could easily back off if things got too much.) Escitalopram is…fine. I mean, I don’t love it, but it’s better than the OCD bullcrap.

So now I take that and the Atarax and really, I need to go take the Atarax now, because I’ve been riding an anxiety wave all day and am staying up late because of it. (BUT I AM TYPING THINGS ON THE INTERNET AND — shut up, justifying-the-anxiety-brain’s-desire-to-never-ever-sleep enabling brain, it is more than an hour past bedtime.)

keelyellenmarie said: July 9, 20135:42 am

It took my first therapist more than half a year to convince me that I had anxiety problems. I walked in the door super depressed and recognizing that fact, but I was actively hostile to the idea that I had an anxiety disorder. Because depression HAPPENED TO ME one day. It had a start and it had in the past at least had ends and I could see it as something-kind-of-outside-of-me. I still felt guilt and shame for LETTING myself get depressed, mind you, but it was an illness that had invaded–before that I’d been perfectly content!

…except, I hadn’t been. Because I didn’t remember a time when I WASN’T terribly anxious, I had to admit how fucked up a great deal of my inner life as a child was. Which, for me, also required recognizing where some of my “perfectly rational and normal” “minor” anxieties came from…the environment in my family (which was often lovely, but was sometimes emotionally/verbally abusive and really not okay!).

After I got all this through my thick skull, I was able to recognize how much anxiety was affecting my life, and realized that I’d had several panic attacks in the preceding years that I hadn’t recognized as such. I kind of categorized them as “temporary insanity due to having really bad depressed nights or too much stress”, but never conceptualized them as being “panic.”

Anyhow, very long story, sorry. You asked about meds:

I took Celexa (SSRI) for my depression, which was supposed to also help with the anxiety. Instead it made me nauseous 24/7 and kind of numbed me to everything. There was less active sad and less panic, but I felt like I was only half there. It was kind of awful. I got off of that after 4 weeks, having lost 15 pounds. It would have been more had my boyfriend not dragged me to the dining halls and forced me to eat at least one (tiny) meal a day.

I next tried Wellbutrin (NDRI) for my depression. Night and fucking day. Amazing. Within hours I felt more awake/alive (if a bit jittery), within a few days I was starting to really enjoy things thoroughly again, and soon I was the least-depressed I had been in ages. It’s still the best I’ve found for my depression, and imperfect as it is, I’m grateful for it. I’ve been on it 6 years now.

The problem with Wellbutrin is that it can have stimulant-like properties in some people, and it makes my anxiety worse at too high of doses, and it’s a balancing act to have me at a high enough dose to not be depressed but at a low enough dose to preclude big anxiety issues. So because of lingering problems with anxiety, and because I got moderately depressed and he couldn’t raise the Wellbutrin any higher without making me anxious, he added Cymbalta. Within a few weeks, the clouds of depression were starting to clear a bit and I was less anxious(panic attacks dropped to less than 1 a month), but I honestly don’t know if that was coincidence (my very stressful final semester of college ended) or the medication. I’m kind of apathetic about the fact that I’m still on this one 5 years in. I mostly dislike that if I forget to take it for even one day, I have significant symptoms (headaches first, then mood swings if it’s a few days), and that makes me feel like an addict….but because of the withdrawal issues I haven’t bothered doing the work to try getting off of it. Afraid to rock the boat.

As for short-term anxiety meds, I take Ativan, which takes longer to kick in than Xanax (though this is supposedly correlated with less addiction potential, something that scares me and so I put up with the slightly longer wait even though in the moment those minutes don’t seem in anyway SLIGHT). Except for a few times when things have gotten very very bad for a short period, I use them infrequently (1-2 times per month) when I’m feeling particularly on edge about a specific event, or when I have panic attacks that I can’t wait out. It helps to know I have them, and sometimes I can talk myself down from an almost-panic-attack just by reminding myself I have access to the pills if it comes to that, so I don’t have to be afraid of losing control. I also tend to use them when anxiety feeds my insomnia. I think they’re pretty much invaluable for this. It’s great to have cognitive/meditative/breathing techniques and all (and theoretically, I’d LOVE to get to a place where that is all I need), but there is a point for me in attack that no matter how much I fight the thought loops, the physical anxiety is just too far gone and I can’t stop it. Knowing I have a “plan B” is just so comforting.

You should write a blog post about allof this, Keely. It would be amazing.

keelyellenmarie said: July 9, 201310:43 am

Thanks. It’s a lot easier writing it here than at my own blog, which my family reads. (Yes, I am aware that my comments here are easy to find, but mostly they don’t look for that stuff and I tell myself if they go looking that’s their problem, where as my blog they can’t avoid because everyone reshares it on facebook and shit.) The one reason I wish I had started that blog anonymously. It’s a wall I’m breaking through slowly… when I want to say something badly enough and get it written, eventually that overcomes my worries about how people (mostly family, but some stuff it is concerning to imagine employers finding it) will react.

redpen27 said: July 9, 20135:56 am

What made you get diagnosed/decide to use medication?

My therapist’s assessment that, after three years of weekly therapy, there were certain things about my anxiety level that had “plateaued” that could be induced to progress by taking medication.

What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)?

To function daily.

Do you like it?
Mine has changed my life (for example, a family member had me convinced I was just not maternal or normal enough to have children and thus needed to have children to prove I was normal but would hurt and ruin the children because I was not normal etc ad nauseum. within a week of being on medication i saw/recognized that my chances of being a good parent are pretty much the same as anyone’s else’s and also partly under my control–like if i decide to have children i can work to become a good parent. these ideas would have seemed insane to me days before). I just had to make it through a crazy month of intense side effects (despite being on a dose so small it is considered subtherapeutic) and endure the continuing side effect (it’s a weird one–5-10-minute panic attacks at 3:30am every day. now that i am used to them i sleep through them most of the time, but if i stay up until that time or have been drinking and am therefore sleeping lightly, i’ll feel it all right). for me, the calculus on that is a no-brainer–the drugs have expanded my perspective so amazingly that the panic attacks seem like a small price to pay.

I’ve been on paroxetine for 8 years. I started taking it when an 11 year relationship was ending, and it felt like my future was being pulled out from under me. I wasn’t sleeping, I was self-harming, I was having suicidal ideation (the kind where I would vividly imagine scenes in which I was killing myself rather than the kind where I was planning an action in the future). It was awful.

I’d had depressive and anxious episodes in the past, in fact I don’t remember every going 2 years without one until I started my meds, and seen therapists, but this was the first time I was ready to take meds when they were suggested by my doctor. I also saw a therapist, and upped my sessions from monthly to weekly, which was really good, but after the two week adjustment period to medication (which sucked, but I had been warned about it, and things sucked anyhow) I could actually think, rather than just have panicky spirals of despair.

I take it daily after breakfast. I find it’s better for me to take it after food, and if I take it when I brush my teeth in the morning, there is more chance of taking it at the same time most days.

My side effects are less libido, occasional anorgasmia, and initial weight gain. I’m fine with those for the most part because the benefits so far outweigh the side effects. Also because for me, eating and libido were often tangled up in anxious thinking, and I’ve been working on body image stuff with the help of blogs like (the no longer active) Shapely Prose and The Fat Nutritionist.

One of the things that helped me get over my resistance to taking meds was knowing people who were open about taking theirs, and talked about their mental health issues. Since then, I’ve tried to model that openness when appropriate, because I know it can be the difference between someone seeking assistance and someone thinking “this is just the way things are.”

I was also LUCKY. My GP prescribed the drug that works for me straight away. It is not one which works for everyone. Some people have horrible effects from it. Luckily, I’m not one of them. I’m still lucky, because it is still working. There is a chance that at some point it will stop working, and I’ll have to find some alternative, but until then, it is something I consider essential.

I have been on various SSRIs for years, off and on. I went on them before I entered therapy, because it was much easier. They made a significant difference in my depression (which was, in retrospect, complicated by anxiety) but ultimately resolving my first major episode was very much a bootstraps kind of thing.

The most recent time, almost ten years ago now, I went into my PCP — I actually had a regular doc for once, not a patchwork of coverage! — and described the situation. She prescribed xanax to get through the immediate situation and an SSRI. We later changed the SSRI, I think, I’m not sure — I’m on celexa now, which has been pretty effective. I’ve started a taper once or twice to get off of it, but I am still on it for now. The main reason to go off of it is sexual dysfunction.

The xanax was originally for emergencies until the SSRI kicked in, about a month. My experience with it initially was so good it was scary (not in an anxiety way): I’d be all spun up and then take a pill and ten minutes later everything was groovy. Like, WHOA. It was shockingly effective, I can see how people get hooked on this stuff. So I have always been very reluctant to take them. But I have had emergency xanax with me ever since, and use them when I can’t defuse a panic attack that is happening somewhere that I am unsafe to let it run its course. (Work. Doctor’s office. Etc.) The last prescription, heh, I was in to see my neurologist shortly after $MAJOR_SCARY_EVENT_IN_MY_CITY, and the way she and her office tech were discussing triggered me. I mentioned it, because she was doing some examination and needed to know about the medication effect — she felt terrible! And immediately prescribed me more, because triggering your patients is just not a good thing to do. (That was my second New Style Anxiety Attack).

Recently, I have used slightly more xanax, because my background anxiety is much higher and so I am more likely to have an attack, and also because my new style of attack is more difficult for me to defuse.

Medication has made a huge, huge difference in my life — but mindfulness is the technique that is the real magic. I have this huge background anxiety looking for shit to latch onto — and my habits of mindfulness are helping to prevent that, because I investigate myself compassionately to see what’s behind that panic over there. It is okay that I am losing my shit over a cloud, that is what triggered me today. I don’t *have* to come up with more scary things! I can accept my background radiation for what it is. My fear doesn’t mean I’m going to lose my job or my husband or anything else, it just means I feel fear. That is okay and that is enough. Meds can’t do that for me. Still more than worth it though.

Impasto said: July 9, 201310:48 pm

My anxiety is comorbid with depression, and I started treatment a few months after I was hit by a car eight years ago. My doctor referred my to an amazing therapist and I also started taking Celexa daily (along with a variety of other meds to manage physical pain). Celexa worked well for me, but after a couple of years it “pooped out” and stopped working; I ended up in the hospital and my psychiatrist switched me to Effexor, which I’ve been on for five years now. I take it daily with all my other meds to be able to function, and it works on both my depression & anxiety.

I still have mixed feelings about Effexor in particular, because it has wicked discontinuation effects that, for me, can kick in if I miss a single dose by a couple of hours. I basically go into instant withdrawl, which sucks beyond the telling of it. I’ve tried reducing my dosage, but then my anxiety flared up, so I’m back to my regular dose and doing well. Given my druthers, I might choose another medication, but I’ve come to accept the fact that it does work for me and I’m not going to mess with it.

I also have Ativan, which I rarely use but always keep with me. I’ll take it if I’m going to a concert (crowds!) or if it’s 3 a.m. and I’m stressing about the fact that I’m not asleep yet. I have had anxiety about taking my anxiety meds (how often is too often, or do I reeeaaaaally need one?). I checked with my doctor to get usual/maximum dosage info, which made me feel much better and more in control. Now, I know if I’m asking myself those questions, I probably should take a pill before I spiral completely.

For me, meds have saved my life and let me live more fully and easily. They may not be for everybody, and there’s often some trial and error figuring out the best fit, but if the benefits outweigh the side effects, they can be a big help.

Katie S said: July 10, 20134:34 pm

What made you get diagnosed/decide to use medication?

Almost losing my job, twice. I’ve almost certainly had anxiety (mostly social) my entire life, but so did my family and my closest friends, and most of my extended circle of friends from extreme-nerd-dom, so I just thought it was one of those things about being geeky and never thought it was something I could get help with. After my dad died I kind of lost my ability to self-censor because it was so much emotional work just to show up at work and do my job that I didn’t have any energy left to put into dealing with people the right way (which does not come naturally to me). Started therapy very resistant to medication, it helped but I was still getting bad feedback on my behavior at work, so I tried Buspar.

Buspar helped. A lot. Also made me very dizzy for the first few weeks I took it, but that eventually subsided. I had energy to be nice to my husband when I got home even after being nice to my coworkers all day. People bumping into me at the farmer’s market didn’t freak me out. It was good. But… I didn’t want to be on it if I was going to get pregnant, so I stopped, and tried to convince myself and my husband and my therapist that everything was going okay. It wasn’t.

Almost lost my job again when coworkers would trigger me and I would lash out verbally out of panic. This time I went back on the Buspar and picked up Lexapro. They started me on 5mg, then tried to go up to 10, which made it so I couldn’t sleep, and dropping back to 5mg gave me the shakes. I’m very sensitive to this stuff. It took a while to kick in, but it definitely helps. I recently stopped the Buspar and found that it was making me a little jaggedy – I would have worse anxiety until it kicked in, then it would be better until it wore off, which I hear is like a lot of people’s experience with Ritalin. Lexapro alone has me covered now.

What do you use and how do you use it (to sleep, to function daily, every once in a while when you’re feeling anxious)?

I use it to function daily. If I never had to go to the grocery store, communicate with not-friends in any way other than e-mail, or be in lines, crowds, or public transit, maybe I wouldn’t need it. But that’s not a life that’s easy to live in my line of work.

Do you like it?

I like the way it shuts up the jerkbrain and I can occasionally guitlessly just be happy and enjoy life. Sometimes I resent that I have to change my brain to make myself socially acceptable. Dad felt this way about the Wellbutrin he took for ADD, so that may have rubbed off on me.

Katie S said: July 10, 20139:01 pm

One thing I forgot to mention that helped nearly as much as the meds (although it was hard to tell because I started it at the same time as Lexapro) was MBSR – mindfulness-based stress reduction. It’s a method of instruction in meditation practice that is often offered through a hospital as a weekly class. I was initially resistant to go, thinking that my problems were not so bad compared to people there dealing with cancer and chronic pain, but it was extremely helpful and I was very welcome there (I wasn’t even the only one with social anxiety).

If there isn’t a class near you, our textbook was Bob Stahl’s “A Mindfulness-Based Stress Reduction Workbook” which comes with a CD. You can also get the meditation tracks from the CD on his website. I found his voice more soothing than Jon Kabat-Zinn’s (the originator of the program).

fistbump MBSR! one of these days I need to take the class again, I was at high anxiety and depression *and* had a death in the family in the middle of it.

dawnofthenerds said: July 11, 20136:16 pm

“I can occasionally guitlessly just be happy and enjoy life”

Epiphany moment. I feel guilty all the damn time, and I think that feeds into and reinforces my anxiety. While I’m in school, I feel guilty and anxious any time I do something that isn’t homework related, even if it’s blatant self-care that I need to be functional, I feel like I should just be able to suck it up and deal and I’m a complete failure if I need any help at all, even from myself. I think I need to talk to my therapist about this and do some deep thinking, because I didn’t even realize I did it until now. It’s just the background radiation of my life. I can remember in elementary school I had to teach myself to tell the difference between feeling hungry, guilty, and naseous, because I interpreted pretty much every weird physical sensation in my stomach region as guilt. I still have a really hard time telling some physical sensations apart (hunger, anxiety, and diarrhea all feel like nasea sometimes). Is that a thing for anyone else?

I have a honkin’ big bottle of Xanax, lowest dose they make. I tried SSRIs, but I am sensitive to brain-altering chemicals to the point of either disaster or wackiness, depending on which chemical it is. I frankly don’t remember much about the months I was on antidepressants — mostly the part about not being able to sleep at all, not being able to recall the beginning of the sentence halfway to the end, and standing in the kitchen not knowing why I got up to walk in there and wondering if there was any way to scratch my own brain, because it ITCHED. My then-roommates tell me that was the only time they ever questioned whether or not they could deal with me in the throes of depression. Whatever is wrong with me, it is NOT fixed by more serotonin.

The Xanax, I like because I only have to take it when I need it. It’s for panic attacks, more or less. I’m given 30-day prescriptions that I actually fill ever 6-8 weeks. I’ve been authorized to take it for occasional insomnia, but frankly I prefer diphenhydramine for that — Xanax knocks me out too thoroughly, and I’d rather deal with cottonmouth than sleep through the alarm.

I got the Xanax in the first place because someone finally listened to me when I said I was dealing cognitively just fine, and the only part I couldn’t seem to handle on my own was when whatever system was supposed to ramp me down from a state of panic went haywire and didn’t work. I did go in last time telling them I’d be equally happy with something that knocked out adrenaline but has no street value, like propranolol. They gave me Xanax anyway.

I wonder if you are secretly bipolar! Or not, I mean, who knows. The strange reaction to antidepressants sounds like that to me, but really if you’ve got meds what work there is no reason in the world to change them.

Just… wow, “my brain itches”. What a feeling. That is like, yeah, your stuff is so not on the serotonin pathway it’s not even funny.

I am not, in fact, bipolar. I investigated that years ago, and both me and the few doctors that have ever paid attention to me agree that I do not fit that diagnosis. The agreement was that I used to have issues at predictable times of year because I was in school, and the issues (e.g., exams, family, etc) were scheduled like that. Since I’ve been out, it’s been entirely reactive with no pattern at all. I just deal with stress very poorly, apparently. In a way, I’d like it much better if I were bipolar — then someone would have figured it out and known what to do with me many years ago.

I’ve known several bipolar people, of varying severity, and aside from the very generic symptoms of not being able to sleep or sit still, nothing about the SSRI reaction is really like how they describe (hypo)mania. I’ve never been in that state before or since, it quite terrified me, and I refuse to get anywhere near any serotonin anything now. The way I described the experience to the doctor was, “Have you ever been dumb enough to take Benadryl on an empty stomach? That, times a million, plus I am still freaking out and depressed.” Apparently the things are structurally related to the anticholinergic antihistamines, and I’m just hypersensitive to them.

Isn’t it, though? I was non-functional on a starting dose of 5mg Celexa, which is literally a quarter of what you’re supposed to be on. I react strangely to a fairly large number of drugs. I looked them all up once, and the only thing they have in common is that they’re all metabolized wholly or partially by a particular liver enzyme — the clincher is that this particular liver enzyme also metabolizes opioids INTO the active compounds, and I discovered years ago that Vicodin and Percocet do diddly and squat for me. I have no confirmation, since that would require an expensive genetic test, but it’s a pretty good predictor of what I’ll react bizarrely to. About 10% of the Caucasian population is “CYP2D6 deficient”, which just makes me feel like my liver is failing its saving throws.

Irene said: July 16, 20137:00 pm

I so wish we knew more about how/why different people’s metabolisms do such different things with drugs. Benadryl doesn’t make me sleepy or hyper either one, and I’m pretty sure that’s genetic because it applies to my kids, too, though not my husband.

@Irene: Given that there are a large number of things I react funny to, and they all share a common metabolic pathway, I suspect I am in the 10% of the Caucasian population that is deficient in a liver enzyme called cytochrome P450 2D6. I don’t know, because confirmation requires an expensive genetic test, but everything that acts wacky involves this enzyme. The most suggestive one is that Vicodin and Percocet do diddly for me — hydrocodone and oxycodone, the relevant opioid ingredients, are actually produgs that are supposed to be metabolized into the real pain-killing compounds via the liver, and evidently in me they are not. They’re totally useless, to the point where last time I just interrupted the dentist and asked how much ibuprofen I could REALLY take if it was only going to be for like four days.

I don’t think I have. I am not sure. I cannot really imagine the sensation. Mr. Wit also says no, he doesn’t think so. Which doesn’t mean it’s not common, or that I haven’t had it, just that the phrase is so evocative of something I cannot imagine….

….but thinking about it makes my head and lots of the rest of me itch in sympathy.

I’ve never experienced it without the “help” of an SSRI. I also got the more standard side effect of pins and needles in my extremities and occasionally my scalp, sort of prickly like you get if you hyperventilate, and the inner restlessness (akathesia) that is also a standard side effect of the abovementioned antihistamines. The brain-itch was more internal. It drove me batty, because while I could scratch or rub my hands and feet to try to override the feeling of formication, there was no way to get my fingers in through my ears and scratch my goddamn dura. One of the few flashes of episodic memory I have is of standing smack in between the living room and the kitchen, gritting my teeth and pulling my own hair in frustration, because I couldn’t make the fizziness STOP.

I too had major difficulties with several SSRIs (although, thankfully not brain itchiness inducing). Mine more centered on lack of affect/ emotional numbness, although zoloft left me a wicked weepy mess and one actually inspired an ER visit due to seriously scary heart palpitations. Now I am on cymbalta which is a SNRI and has been life altering. No more waking up mid panic attack and only rare sleepless nights. I an actually drink caffeine again!🙂 Although I do still have the occasional bought of depression. :-\ I am glad you finally have a regimen that works for you!

I also do very poorly on things that inhibit GABA, which is the neurotransmitter that ramps everything down once the crisis is over, or is supposed to. Most SNRIs (and NDRIs like Wellbutrin, and DRIs like stimulants) lower GABA levels, which is exactly the opposite of what the helpful Xanax is meant to do. The only stimulant I’ve not found to be extremely unpleasant is actually caffeine, which doesn’t touch the GABA channels until you get up over 500mg or so. Sudafed (pseudoephedrine, related to amphetamines and a close analog of adrenaline) is hell. Selective norepinephrine reuptake inhibition itself may or may not be a problem (epinephrine, aka adrenaline, is the primary culprit in the physical symptoms of a panic attack; I probably wouldn’t like it much), but the other effects of drugs like that are things I need like I need a hole in the head. I’m glad it helps you, though!

TinyTeacher said: July 8, 20137:25 pm

I have been in counseling for anxiety/depression for almost a year. Some things that have helped me (YMMV):

– Prozac: so that I am not a raw nerve experiencing every little emotion anyone has in my vicinity as an attack on my self.
– Ativan. I take this one every few months. Mostly, like a previous commenter, it is just nice to know I have the option.
– Team You: finding a therapist I trust, keeping my one true love up to do date on my emotional state, etc. When I get anxious (or hungry, or have a migraine), I essentially lose all ability to problem solve, and regularly need outside stimulus to figure out what the hell I should be doing. Sometimes I imagine calling my one true love, and I can walk myself through what she would tell me to do.
– Don’t feed it. I get really anxious about going out. Anywhere. Grocery store, park, for a walk, etc. But I have learned that those feelings of fear aren’t based in anything real, and I can’t reinforce them by doing what they want (staying in). As soon as I get scared to leave, I have to put my shoes on and go. Otherwise, I’m stuck at home, scared and increasingly depressed because I am lonely and apparently useless. (Jerkbrain.)
– Use a calendar and look for patterns. My phases of intense anxiety and depression tend to be pre-menstrual. When I can make the connection between the hormones and the feelings, I don’t go around looking for The Thing that must be upsetting me. I just say “I feel sad.” And it helps me and my team to know that the sad will go away, but it is real right now, so I can just feel it and move on.

I’m still anxious a lot of the time, but it is less crushing if I don’t let it get on top of me. But that means using a lot of WillPower Muscles to push past discomfort, and sometimes I don’t have power left in them. Sigh. It’s hard. Plus, you know, working and laundry and life.

I’ve had several occasions recently wherein I could source my anxiety to some Big Important Task that I’d been putting off for a long time – months or more. Usually the tasks involved making a phone call, since those are the ones I’m mostly likely to put off indefinitely, but not always. The anxiety would get higher every time I thought about doing it, because omg if I haven’t done it by now I’m such a failure already and whoever I need to talk to about (thing) is going to think I’m stupid and ridiculous and I Can’t Have That. So it would lead to a big anxiety-guilt spiral, with a nice dose of self-loathing mixed in just in case I didn’t feel crappy and incapable enough. Eventually, I realized that the only way I was ever going to feel slightly more functional was to just Do The Thing. Make a list of everything I needed in order to accomplish my task, rehearse the answer to any likely questions, have every paper I could reasonably need sitting in front of me. Having all of the information I needed helped a lot. I’d consider making the call, but then realize I didn’t know what the phone number was and then I’d freak out about how I was never going to be able to do it. By breaking it up into smaller steps – my goal for today isn’t to make the call, it’s just to find the phone number – even though it didn’t seem like it should have been an unweildy task, it was made so much easier. And eventually I managed to actually make the call, after usually weeks of preparation, when I was having a day good enough that I could handle the anxiety but bad enough that it was still a motivator.

It felt amazing. For the first time in months, I didn’t have (as much of) a sinking feeling in the pit of my stomach because of this impossible, totally simple task I wasn’t doing. It’s something I have a really hard time with doing, and clearly isn’t for everyone – getting the energy and presence of mind to actually do something that anxiety-ridden was hard as fuck for me, and I imagine is for other people as well – but I try to remember how good it felt whenever I get that sense of overarching anxiety and failure, and think of what it is I’ve been putting off. (This works for me because I can usually tell the difference between “Oh god I can’t make a phone call what kind of failure am I I’m probably going to owe $10000 by the time I make the call I shouldn’t bother I suck” and the stuff I deal with more often. YMMV.)

Ariel said: July 8, 20137:50 pm

I don’t have any problems with social anxiety, but I do have anxiety and panic attacks related to breathing issues. I have some damage to my throat and lungs from having bronchitis and pneumonia about a dozen times, and it causes horrible horrible coughing fits that often keep me from breathing.

So this year I started getting panic attacks about breathing. As you may know, one of the symptoms of panic attacks is hyperventilating or difficulty breathing. So I get struck by mysterious fear, start hyperventilating, then I think I can’t breathe, that makes me hyperventilate more, which makes me more scared, and then we’re in a full-on gasping screaming crying please-take-me-to-the-hospital-right-now panic attack.

I’m really lucky to have a totally awesome therapist and the money to pay her. She’s helped me discover that the best way for me to avoid the attacks is to logic my way out of them. My major anxiety is that I’m not “just” having a panic attack, I’m actually suffocating. So we brainstorm all the possible explanations for feeling like I’m suffocating and we rule them out until no explanation is left but a panic attack. I can’t be having anaphylaxis from allergies because there’s been no common allergen to account for all my attacks. I don’t have asthma because my respiratory specialist has done lots of tests and I trust her. I can’t be having side effects from my medications because none of them cause difficulty breathing. And so on.

I tend to be a logical-minded person, and my therapist figured that out pretty quickly. So she figured the best way to help me come to terms with my panic attacks was to convince myself that the simplest explanation of all the facts is that I have panic attacks, not that I’m actually dying. It’s worked super well. I still have mild anxiety pop up every day or so, but it never goes beyond an uncomfortable feeling about my breathing, and it hasn’t caused very many problems. Instead of thinking, “Oh no I can’t breathe I’m gonna die,” I think, “Oh, I guess I’m having a panic attack. Drat.” And then the fear sort of slowly edges away instead of getting worse, because I accept it as randomly-generated fear, instead of thinking it’s “real” fear. No panic attacks for a month, wooo!

And that’s how I convinced myself not to have panic attacks. I know my story probably doesn’t help anyone with social anxiety very much. But I feel like these conversations tend to be heavy on the social anxiety side of things, so I thought I might weigh in with this. Hope that’s okay.

I, too, have physically triggered stuff. I have vertigo. People with chronic vertigo really, really frequently end up with anxiety disorders. I can’t think why! It’s not like a sense of up and down is useful for any part of life! Just yesterday I cut my foot open because I lost my balance suddenly while walking out my back door onto my own deck. I have been trying things like ginger tea and weighted blankets, because “maybe I will fall over and hurt myself” is properly answered with, “Yes, that’s fairly likely,” and…yeah. Having awareness of potential harm without anxiety is being pretty hard right now.

cleverhound said: July 9, 20134:02 pm

Oh, yes. I have a fainting disorder, and a thyroid disorder. The physical symptoms just went into a slush pile with anxiety problems and it took a long time and lots of work with a therapist to be able to sort that out. Because a cloud of “You Could Pass Out At Any Time!” following me around all the time had progressed to me being afraid to leave the house. Damn chronic conditions!

+1 on this. I have asthma and, like Mris, have vertigo. After a serious health scare a couple of years ago, I also have specific OCD brain raccoons that interact with health fears (it’s a bit like having the WebMD “you may have (a) a cold or (b) horrible death” symptom checker living in my head). So here I am with shortness of breath and pain when I breathe, which could be an asthma attack, or could be a panic attack, or could be, I dunno, a heart attack. My system is a bit like yours – first logical step, take inhaler. If that doesn’t help, take an aspirin (mostly to get my brain to shut up about the stupid heart attack already) and do meditation/breathing exercises for ten minutes. Better? panic attack. Worse? Okay, then you can give up and call an ambulance.

I’ve never made it to “call an ambulance” but somehow knowing that there’s a point in the process where I’ll give up and do so makes me able to get through steps one and two, which solve the problem.

Impasto said: July 10, 201312:30 am

I have similar anxiety around breathing issues, due to allergies (perfume/scents and dust are usually the culprit in public). It’s not an anaphylactic reaction, but my throat tightens to the point of passing out, so I used to panic at the onset and that didn’t help. It took a couple of years after my allergist’s diagnosis and getting treatment, but I’ve gotten to the point that I can recognize the symptoms as they occur without the accompanying panic. If someone’s bathed in perfume, I leave the area, throw on a mask, and/or do vocal exercises to relieve symptoms (which mostly consist of hissing like a snake, so I pretend I’m speaking Parseltongue). For a long time, I did feel anxious and self-conscious about wearing a mask in public, but just in the last few months I’ve finally gotten to the point where I don’t care what people think – I just do what I have to do to stay healthy and breathe.

Which is a long-winded way of saying that knowing what the root of the problem is can go a long way to help you feel in control, and learning how your own body reacts over time can sometimes help you reprogram anxiety responses triggered by physical issues.

Marwen said: July 8, 20138:01 pm

Biggest breakthrough for me, with my anxiety, was realizing I can be anxious without anything causing it.

Because much like with my depression, previous to that realization, I would always try to find A Reason. I felt anxious, ergo clearly something was causing the anxiety! I was depressed, so something was making me sad! And if I could just identify what those things were, I could fix them, and everything would be fine!

In my case, nuh uh. And in fact, in my obsessive search for The Reason I Was Anxious/Depressed, I would make things to be anxious/depressed about.

Realizing that the cause-effect was that way around – that the feeling/mindstate existed, and was simply latching onto whatever seemed most advantageous to it at the time, rather than vice versa – has been super helpful, particularly in mindfulness exercises. It allows me to go “ah. I am having a bad anxiety day.” and simply go on from there, without trying to Solve Things that, in fact, did not need to be Solved.

I have a general anxiety disorder, which kicks into high gear in winter because I Do Not Cope without sunlight. Part of this feeds into not taking care of myself which means that I lack the physical resources to do anything about my brain paralysing me. Unfortunately, I’ve found that a side-effect of most psych meds for me is both tachycardia and anxiety. Which is INCREDIBLY unhelpful. Things that I have found work for me:

Shut down. Do Not Think about the big scary thing. It doesn’t help. If the Big Scary Thing is something that you have to do, then break it down into smaller tasks. The Captain’s post here the other day was a really good reminder that I don’t have to do ALL OF THE THINGS. I can do part of them, or as much as I can manage and I will still be better off than I was before. My therapist likened it to staring at my footing/where I’m putting my hands as I’m climbing a mountain. It stops you from getting dizzy and falling over.

Ask for help, if you are able to. My parents had me over for dinner the other day and my Mum looked at me and said “Are you ok.” and I said “I’m kind of failing at being an adult” and started to give the “BOOTSTRAPS, SELF” talk which… doesn’t actually help because I am not capable of bootstrapping myself right at the moment. And she said “Well, can I cook you some nutritious meals and bring them over and you can freeze them? That way you will at least have something to eat.” Small practical things. Ask a friend to bring you dinner, tell someone that you’re struggling, ask for their help in chucking out the mountain of garbage. My Team Me is pretty awesome, and I have done the same for friends when I have been able to.

Sometimes you need time to heal. Sleep. Be kind to yourself. Eat what you want to. Give yourself rewards. Rewards that work for me: hair baubles (I have an ENVIABLE collection), books and DVDs.

Therapy has been super useful for me. She had me “unpack” the thoughts that lead to a panic spiral/panic attack, and then when I was in a good place, we examined them one by one. And the majority of them turned out to be Not True, or exaggerations, because my jerkbrain is a huge drama llama. She also helped me understand what was going on physically during a panic attack, and now I am less likely to panic more if I can unpack the chemical cascade in my body and go “Oh yes, epinephrine leads to vaso-constriction and increased heart-rate, this is what I am feeling.” Understanding what’s happening has been huge.

Her advice during a situation that’s making me anxious is to withdraw, but don’t totally leave. If it’s the queue in the bank that’s making me anxious, step out of the queue for ten minutes and sit to the side, running through breathing exercises. If anyone says something, say “I’m feeling dizzy, it will go in a second.” (Which is true, and all anyone needs to know.) Then try again.

Exercise generally improves my mood, if you are capable of it. In addition, exercising hard enough so that I was able to recognise the feeling of being short of breath and the different levels and when is “OK, this will go away” and when is “This is an asthma attack, get your puffer” and “You need to call the ambulance now.” (Obviously, medical supervision, etc.)

Silence said: July 10, 20131:33 am

Since you mention a lack of sunlight being a trigger does vitamin D or a light box help?

A light box doesn’t help (besides being expensive and almost impossible to find in Australia) but Vitamin D does. I’m almost always deficient (last measurement was 17 /o\ . normal is 30-55), and even with taking supplements and fortified foods it’s a struggle to get my levels up. A combination of exercise, eating healthily and vitamin D supplements has worked for several years to keep me functional-ish enough that I haven’t needed to take medication, but this year the wheels fell off with injury, etc. I am… sort of, I hope, coming out of the woods now, but it got bad enough that I was seriously considering meds as an option.

I suffer from social anxiety, general anxieties as well as schizophrenia and bipolar disorder. I can usually keep it under control, but after a while of it building up I can end up having problems. I was given an anti-anxiety medication after I got out of the hospital around thanksgiving of last year, but I can’t get more until I have the prescription updated which costs a lot.

What helps me feel better is not only a quiet, fairly dark room, a nice cup of warm tea and some soothing music (or ASMR videos, those are awesome) but having a cat or dog to cuddle with, a warm blanket and preferably at least a few hours of quiet time in a room to myself.

Some people might be interested in this as well: http://www.ecuad.ca/node/2873 it’s a scarf/shawl for people with autism (it specifies children, but I think anyone could use it) and it could probably help people with anxiety a lot too.

Leo Chao, a student at Emily Carr University, designed the Beagle, a scarf that people can wrap around them. Texture, sounds, and even smells create a calming cocoon that will distract and soothe an autistic person when they’re feeling over stimulated. It’s the electronic version of a blankie that has actual health benefits.

For someone with anxiety, it could be perfect for public places or other situations when one can’t escape to a nice, quiet place to reset for a while. Just something to calm you down until you have a chance to unwind. If it becomes commercially available, I’d certainly like to buy one.

Mer05 said: July 8, 20139:11 pm

I too grew up in the House Where Mistakes Were Not Tolerated And Shame Was High (tm songofmyself). And as the cherry on top, seeking professional mental help was held to be a sign of weakness.

I think what helped me most was figuring out what I want to do in life. After I realized that marriage and children had not made the list, I quit dating. I haven’t ruled out seeking therapy and doing the work to make dating a less anxiety-ridden, torturous thing… but I have other hobbies.

On the other hand, I really wanted to travel, so now I travel. Turns out, I’m way more zen about looking like an idiot when I am, in fact, a clueless tourist. One of my favorite memories is knocking on a total stranger’s door to borrow a corkscrew, which I would never do at home. (…It turned out the bottle was a screw-cap, but hey.)

MamaCheshire said: July 8, 20139:15 pm

Two things I add from personal experience:
– Sometimes anxiety *symptoms* are what you go looking for help for, and you end up with a diagnosis of something else entirely.
– Anxiety-esque symptoms can be secondary to almost any mental health diagnosis because stigma related to being Crazy On Paper sucks like that.

Eight years ago, Spouse went in for “depression, anxiety, and trouble sleeping”. Soon thereafter, his bipolar disorder was discovered “the hard way” when he had really over-the-top and scary manic reactions to two SSRIs and a tricyclic antidepressant, ended up in a partial hospitalization program, and someone finally thought to ask about dysphoric/irritable manic-type symptoms in his past history, which can look an awful lot like “depression and anxiety”.

Five or six years ago, Spouse almost ended up with a secondary diagnosis of social anxiety (anyone who knows us both will probably be laughing their asses off at this). Why? Because he was scared of getting close to people and them finding out he had Evil Scary Bipolar Disorder and maybe deciding that it would be a good idea to call CPS on him because obviously he’s a danger to FirstKid (at the time, FirstKid was our only kid and Spouse was a full-time stay at home dad) or some such nonsense. I think somewhere in that time frame was when someone figured out that he also had PTSD courtesy of the abusive fundamentalist cult he grew up in without realizing just how abusive and fundamentalist and effed-up it really was.

Four-ish years ago, my BFF was totally convinced that I had some kind of anxiety disorder and started poking at me to get it dealt with. I have a specific phobia that occasionally is somewhat life-interfering, but I’m often more than half-convinced that NOT having it would be even MORE life-interfering. (The phobia is of heavy traffic, especially driving in it. Mostly because my depth perception Does Not Work Right and I know it.) And then I found Sari Solden’s checklist of “Hey, ADHD sometimes presents differently in women, you know!” and realized that checklist could have come from sticking a flash drive in my brain and downloading my specific variety of brainweasels. (And then Spouse very sweetly held my hand while I went to the doctor and said, “Um, I think I have ADHD, and it’s messing up how I’m dealing with my kids and my job, please help me?” and he also attested to every symptom from the inattentive checklist and more than enough from the hyperactive/impulsive list as well.)

Because, see, I DO have a lot of restless anxious thought processes, and other than the heavy traffic thing, about 90% of it is variants on the theme of “oh fuck, I failed at adulthood again, didn’t I?” Meds for the disorder I actually DO have, plus awareness that I have it, has lessened what I think of as the secondary anxiety as well. (Even the traffic thing, because apparently a lot of people with ADHD have issues with depth perception, and instead of being “oblivious” or “reckless” about it as the stereotype would have it, I’m over-cautious most of the time about giving MORE THAN ENOUGH distance. Having a minor mobility impairment caused by being hit by a car as a pedestrian when I was 14 probably has something to do with that, too.) Except for the part where this means both adults in this household are Crazy On Paper and therefore presumably unfit parents, which pisses me off as a newbie social worker who had to hear this shit from classmates on more than one occasion. 😦

Because this IS an anxiety thread, I just wanted to let y’all know that the spamfilter seems particularly voracious tonight, sucking in lots of comments of newbie commenters and regulars alike. And I dunno about Jennifer, but I’m going to bed (it’s an hour later where I am than where she is).

So if you crawl out on a limb and expose your inner foibles, and your comment goes into the void, please don’t interpret that to mean that an actual human being has read it and thinks it, and you, are worthless or redundant or annoying or inappropriate or anything else Jerkbrain may be suggesting. It just means that your comment is in purgatory with all the weird blogspam for cheap shoes and pens and who knows what-all in non-roman characters or weirdly ungrammatical English. It will be back.

JenniferP said: July 8, 20139:51 pm

Yes to this! We will get to it as soon as we can. I have *more* time to moderate than usual but that doesn’t mean 24/7.

So, does anyone have any suggestions for polite ways to handle that very annoying thing people do when you say “I have OCD” and people go “teehee, I have ocd too! I totally hate it when something gets out of place in my home, isn’t that cute?” (that’s my disorder. I’m sure people do it for other ones too). My impulse is always to smack them down with the diagnostic criteria, and I’d like a better response.

JenniferP said: July 8, 20139:57 pm

How is your sarcastic voice? Do you have a good one? Because if so, a curt “Yeah, it’s exactly the same” might work to let them know they’ve made a faux pas but save you from having to go fully into it.

Badger Rose said: July 8, 201310:12 pm

I find that a level stare, combined with, “I mean, I’m diagnosed with it as a medical issue,” and no amusement in my voice or face, works well.

In the 98% where they’re making an idiot joke, it tends to make them feel embarrassed, which they ought, because it’s not a joke.

In the 2% where they are also diagnosed with it as a medical issue and have a bad way of conveying that, they can say “Yeah, me too,” without humiliation on either side.

JenniferP said: July 8, 201310:30 pm

This is much better than my suggestion.🙂

Pterinochilus murinus said: July 9, 20139:02 am

I hate that too. I have OC symptoms secondary to anxiety, not OCD on its own, and it doesn’t help that mine’s mostly obsessive ruminations, and most of my compulsions aren’t the ones people have heard of like hand-washing and cleaning and counting.

Smacking them down with the diagnostic criteria sounds like a perfectly good response to me. Or maybe a shorter version would be just saying “Is this a disabling condition for you? Something that interferes with your day to day life?” and if they say no, “Then it’s not OCD.” If it does interfere with their day to day life, that’s a different discussion.

cleverhound said: July 9, 20134:08 pm

*fistbump of solidarity for the OC with anxiety stuff, and the ruminations and whatnot*
which is my way of saying, feel ya, totally have that too.
My response is sort of a sarcastic “Oh, yeah, I have an actual *medical* condition, but your thing is nice too.” But sarcasm is my default response to life.

The one I think about but don’t say is “Oh, yeah, I have obsessive thoughts that I will accidentally murder people! How funny!”

(And then I worry that I will accidentally say that out loud some day. Because there is no unreserved victory.)

If you’re online having the conversation, author Seanan McGuire has two really good posts on the subject – one is here and it links to the other. In person, if I’m disclosing anyway, I usually go for “oh, I’m sorry to hear that” because it makes them stop and think about what they said and what I said. Or I’ll ask if they’re currently pursuing treatment or something, something that indicates I’m taking them at their poorly-chosen word. And if, like Badger Rose said, they’re serious too (because sometimes I know I am not the best at being Srs Discussion Person) then it can be made clear without as much awkwardness.

WKP said: July 9, 201312:06 pm

I really like that idea. They’ll feel awkward and uncomfortable and hopefully remember that experience the next time they start to say “I’m so OCD”, and consider their words more carefully.

BunnyManders said: July 8, 201310:06 pm

I’ve been lurking round these parts for a while, but I just had to come out of the woodwork for this thread. Hi everyone! *waves*

I have generalized anxiety disorder, which is very well controlled these days, and a phobia which I cannot get under control at all. I developed a fear of flying literally out of the blue: I took a transatlantic flight in one direction and was fine, but was a mess on the return trip, and even since I’ve had panic attacks every time I fly. Just thinking about booking a flight makes me cry.

The bummer is that I have something called a paradoxical reaction to the most common sedatives for fearful fliers. I’d like to try beta blockers, but if they don’t work, I don’t think I’ll be able to solve this with pills alone.

I’ve tried a couple of different talk therapists and had terrible experiences. There wasn’t any traumatic experience that brought this on; I was fine with planes one day and terrified of them the next. Exposure therapy would be a good idea, but planes are expensive and the therapists I’ve tried couldn’t come up with a way to make it work. Virtual reality therapy does not seem like a good idea for me. I would like to try hypnotherapy, but I’m having a hard time telling the genuine therapists from the quacks. I think cognitive behavioral therapy would be just what I need, but again, the therapists I tried were less than helpful and I only have so much time and money to spend on fixing this thing.

I know that this is the jerk brain talking, and there are definitely therapeutic methods out there that would work for me if I just keep trying to find them, but every time I have a bad experience with one method it feels harder to get out there and try again. So, people who learned to deal with phobias… how did you do it? I would love to hear some success stories right about now.

PS another weird thing: several members of my family, all from different generations, developed an intense fear of planes in their late teens/early twenties just like me. I asked how they were able to fly again, and they said things like “one day I just got over it” and “I just had to fly for something important and it was fine.” I know anxiety disorders can be genetic, but that is a super strange coincidence.

keelyellenmarie said: July 9, 20132:27 pm

That is a really weird coincidence. I wonder if there could be some kind of weird physical quirk that makes something about the plane ride itself (some kind of over reaction to altitude changes, maybe?) trigger anxiety symptoms in you/your family members? Now that I say it, it sounds quite far-fetched and hard to test, but maybe?

BunnyManders said: July 10, 20131:03 pm

It could be! Quite a few family members on both sides faint when they get shots and blood draws, and I definitely inherited that. If the phobia does come from a physical quirk, which type of therapy would be best?

keelyellenmarie said: July 11, 20131:56 am

I’m not a doctor, just a curious biologist theorizing. I think the treatment would still be the same, though medication might be particularly useful if the trigger isn’t purely cognitive. Do give beta-blockers a try if you can find a doctor who will work with you on that though… I have a friend who has panic attacks often triggered by palpitations related to a minor heart defect (discussed elsewhere in this crazy thread), and she’s found it helps. Beta-blockers work totally differently than typical anxiety meds (they make your heart unresponsive to adrenaline, basically), so it doesn’t necessarily follow that they won’t work just because the other pills were problematic.

Itzuken said: July 11, 20133:49 pm

I had a phobia of flying for a few years that came on very suddenly – I went from “Flying! Whee!” to “Uh, I dunno if I’m cool with this” to “Oh god I’m sure I just felt the engine fall off the plane” in the span of a few months. It was worse with turbulence and on small planes, or when I couldn’t see out the window (I had this absurd fear that someone could put a concrete wall in the middle of the takeoff strip). It got pretty bad. It faded with time (I still get nervous but not panicky); two things I can pinpoint that helped were A) learning more about planes and how they work – it really was good to know that planes don’t randomly nosedive even if something goes wrong, which is how it was in my head and B) sneakily listening to music during liftoff (which is when I got the most anxious) to focus on something other than the anxiety and to pretend that I was on an exciting – but SAFE – roller-coaster. The specific song that worked wonders for me was Super Taranta by Gogol Bordello – decently long, exciting, relentless. I have no idea if these strategies are what actually helped fix it or whether it just faded with time, but they did correlate well. I hope you find some of this useful! Good luck.

Imbri said: July 12, 20131:07 pm

Something similar happened to both me and my sister? All through our teens we were perfectly fine with flying all over, and now – bam. Anxiety out the wazoo with zero idea where it came from. I’m not sure if my sister has the panic-attacks, but if I’m sitting anywhere but ‘My Seat’ on the plane I get super dizzy and the little ‘you are going to faint’ cracklies start up on the edge of my vision.

My only guess (and this is seriously just a guess!) is that… when I close my eyes on a plane, I feel ‘spinny’ and I don’t know where in the sky I am because there’s nothing to tell me where gravity is and if I just go by sensation gravity is in the _wrong place_. I described it to a friend as something similar to sitting in a swivel chair and closing my eyes. When I do that, I feel like I’m spinning in a circle. I’m guessing that something wonky is going on with whatever’s in my head that deals with orientation and gravity and my brain does NOT like it.

Sister and I have the same coping mechanisms (come up with independently, which baffles us both).

I (we) have a particular seat we sit in every flight (we do Long Distance Relationships, so flying is/was semiregular). I sit in the seat above the wing right next to the window so that I can make sure I remained oriented. If I look out the window, there are wings. I can press myself up against the bulkhead and LOOK at the wings and go, “Ah, yes, the wings are still there and I am oriented in this fashion to gravity.” I think that’s because both she and I replaced the jacked up signal processing that our brains our doing with visually orienting ourselves. Also, knowing where the side of the plane is just for the sheer comfort of having something there to press against is infinitely calming. I’m not spinning through space if I have the bulkhead to keep me stable.

My sister has a history of requiring the visual orientation in cars. (Sitting in the back seat made her carsick. She had to face forward and be able to track the road out the windshield.) And I have quirk that is me usually having to drive because otherwise I can’t ‘feel’ what the car is doing relative to the road. Both of these miiiiggghhttt be super mild versions of the same thing?

I don’t know if this is at ALL what you’re going through, but it was similar enough to my Sudden Onset Airplane Panic that it was worth a shot.🙂

BunnyManders said: July 15, 201312:05 pm

That’s it! That’s exactly what makes me panic, especially on takeoff when the floor *looks* level from my perspective but I know it’s sloping. Sedatives make me dizzy, which certainly did not help the situation.

I’ll check out the beta blockers suggested above, and I’ll see if there are any therapists in my area who could work with me on that.

Thank you to everyone who replied. One of the worst things about having a phobia (besides, obviously, the phobia itself) is feeling like you’re the only person in the world who’s unable to do this thing that thousands of people do every day.

I started having panic attacks a few months before I got married (and those were related, although it took me years to realize it). I ended up at the ER because I just couldn’t stop hyperventilating and generally freaking out. That led to me working with a really good therapist while also taking meds (Paxil and Klonopin) for about a year until the talk therapy helped me become steady enough that I was able to stop the Paxil. Klonopin has remained my buddy, but one that I only have to take about once a year. I was seeing my therapist regularly until a few months ago when a health crisis forced her to take a break from work. (Meaning that my relationship with my therapist has lasted longer than my marriage!)

All of this started for me 16 years ago, and I haven’t had a full-blown panic attack for about 12 years. I have had mini-episodes of high anxiety that I can usually work through. I tend to get into really high anxiety moments when I am feeling like what is going on around me is out of my control. Oddly enough, if ever in a truly critical situation I can usually muscle through it, but when it is not “life or death” I can get into these high anxiety episodes. Crowded movie theater? Concert? Renegade Craft Fair? All situations where I either had a full blown panic attack or had to skedaddle before I did have one.

In fact, I just had an episide last night as I was going through security at an airport. I am really, really not comfortable with going through those machines at the security checkpoint and usually insist on the pat down instead. However, I was given such a hassle with it during my outbound flight from ORD that I didn’t ask for it during the return flight. I just dreaded trying to push through getting a hand pat down (they make it really, really hard to do that these days and will argue with you all the way) so I gave in and went through the machine. I had a mini-freak out when inside the scanner, so much so that I ended up getting a hand pat down anyway.

Other things I do to manage my anxiety are to try to recognize when I’m feeling uncomfortable and just be kind to myself. My friends know that I have to manage my exposure to crowds and just accept it, otherwise they’re not my friends. Sometimes I’ll try out new situations and if they aren’t working out, I have an escape plan (Klonopin). After the episode is over, I’ll try to find some quiet time to think through what was happening inside my head so I can find the pattern and/or figure out how to minimize the chance of it happening again.

My panic disorder and anxiety is not considered agoraphobic because it’s not just in crowds that I ratchet up. I’ve had the same thing happen while going on visits to my parents or my boyfriend’s parents. Travel seems to be something that elicits a lot of anxiety in me, but is something I also enjoy. I just try to figure out what little things I can do to make myself more comfortable (packing food I enjoy, planning for contingencies, etc) and do that so I can find the enjoyment and overcome the discomfort.

keileya said: July 29, 20132:05 am

I am super late to this thread, but: you can actually get through airport security without the pat-down and without going through the scanner in most airports. If you tell them that you can’t hold the arms-over-head pose required by the scanner, they are supposed to send you through the metal detector, not do the pat-down. (In my experience, they do it without question 90% of the time, 8% of the time they go off to get somebody to do the pat-down and that person says “don’t be an idiot, she goes through the metal detector”, and 2% of the time they do the pat-down anyway. I’m okay with those odds.)

They don’t have to know that you can’t hold the position for the scanner because of anxiety issues or because it freaks you out!

There’s also a program called “TSA Pre-Check” that reduces the amount of security theatre you have to go through, but it costs money.

tired of something said: July 8, 201310:19 pm

Wellll… I have PTSD which remits sometimes and is incredibly intense at other times. In terms of what has helped, I have done a lot of therapy! It was most helpful in teaching me that I can handle anything and survive it, and in reminding me to challenge the negative thoughts in my head (I have to admit that the jerkbrain idea does not resonate with me – it is pretty important for me to be gentle and accepting of myself, so I try to be gentle with myself when I think negatively about me).

I can’t afford therapy right now, so my best strategies involve some combination of focusing on my breathing, staying in the moment, and distracting myself when I need to. When it is bad, I do grounding activities. I try to engage in a LOT of supportive and helpful self-talk. When I am anxious about future events I try to gather a reasonable amount of information about the space and choose environments that are manageable to me (that I can leave easily is usually the key). But in social environments when I want to flee, I breathe and remind myself that staying will reinforce the anxiety, and I can leave, but only once my heart stops racing and I feel calm, and usually by then it is ok. Mostly I engage in some balance of trusting myself (does this feel unsafe, or am I actually unsafe), and acting on that. I don’t expect other people to understand what is going on for me, but I do expect them to respect my boundaries.

Beyond that, I find that it helps when I force myself to do the basics, always, no matter how bad things are, I try to take a walk every day, shower regularly, eat regularly, and get enough sleep. I am attentive to my breathing, and make sure to breathe in and out! Also, I keep my journal on me at all times, I create music, and I dance as much as I can – anything that creates a physical release helps me (occasional masturbation is part of that too!), as does a sense of comfort. I also find that my clothing being comfortable helps me a lot, to not feel self-conscious or physically restricted. Basically, if I find something that helps and is not a form of self-harm, I do it. For me, a lot of this is the ongoing (and this has often supported by a therapist) learning to trust myself that I am the best judge of what is working and what is not working, and what I need.

twomoogles said: July 8, 201310:24 pm

Largely as a workaround for my anxiety, I tend to be hyperlogical about feelings, particularly my own. I am usually very good at separating ‘This is a Feeling I am Having’ with ‘I must Act on This!’ This can be a positive sometimes–I am highly self analytical. But this can also paralyze me further when doing anything at all. I start analyzing and predicting everyone else’s reactions in the same way I do my own. So if I write a post on a social justice-type of blog, I worry I will accidentally offend someone and *everyone will hate me*! If I’m at a party, make a joke and nobody laughs, I then get the twin feelings of ‘ugh, I am failing socially’ and ‘no I’m not, nobody can tell but me, my brain is just being stupid’.

Also for me, I really hate the idea that someone might not tell me something I was doing is bothering them. Particularly something like ‘oh, she has anxiety, so I am not going to say anything to her that might set her off’….wait, what? What would they normally be saying to me??? They are not telling me something they would normally tell me, and are building up resentment, and so will *hate me*!

The thing that sets me most into panic attacks has to do with jobs/school, to the point where I won’t really go too far into it because I don’t want to set myself off. When it’s not one of those issues, I can usually keep it to a dull roar, as it were. It’s frustrating too because nobody likes looking for jobs, so when I explain that even the idea of looking at a cover letter I’m trying to write will have me shaking and crying, often people assume it’s just along those lines.

lilaengelrocket said: July 8, 201310:25 pm

i can’t remember a time in my life when depression and anxiety were not an issue. it got really bad around the time i entered high school and it has been both better and worse at different points since then. looking back as an adult, i am able to identify many instances in which my depression and/or anxiety caused me to behave or think in a certain way, which would have been different for someone without those issues. in short, i have never known how to feel or function without depression and anxiety.

the 2 biggest problems i am having right now feed into each other. my anxiety is worse when i’m alone because no one’s there stop me or distract me from spiraling into a frenzy. however, being around people is terrifying. i have had a diminishing circle of people for the past 7 yrs or so. apparently, i’m very bad at choosing friends. my experiences in the past 7 yrs have made me mistrustful of people and those who have disappeared from my life have not been replaced. at this point in time, the only people i really talk to on a regular basis are my boyfriend, whom i live with; my dad, who lives in a nearby city; and a good friend, who lives in a rather far away city.

in October of last year, i was bullied into quitting my job by HR because of an injury and an idiotic nurse who just didn’t know how to write a damn note. after that, depression took over. i spent all winter sitting around, drinking and crying. my dad was really supportive, tho, and has been helping me out financially for almost a year now. i feel a lot of guilt about it even tho he always assures me that he’s glad to help. he has never once done anything to make me feel guilty about it but my mom has. even tho she tried to apologize, the damage has been done. i don’t really keep in touch with her since i moved out. i do see her when i visit home but we’ve never had the best of relationships. she and my dad are still together and i think they always will be. so the guilt also feeds into my anxiety because i just drive myself nuts worrying about money and how i should be working even tho i’m still in a lot of pain sometimes. so i shame spiral at the same time as being paralyzed by my anxiety, which puts me in a place of not being able to help myself and feeling horrible about it. i’ve not really figured out a good way to handle this except to just congratulate myself as much as possible for the things i am able to accomplish on any given day.

i probably could realistically be working and managing my pain effectively but it’s the anxiety that truly keeps me from even trying. how i lost my job was so devastating. my employer’s blatant lack of concern and respect for me as a person was really hard to deal with. much like not making any new friends since a specific incident with a close group about 7 yrs ago, i am not eager to find a new job. i realized recently that it’s really not the experiences that frighten me. it’s my emotional reactions to experiences. i’m more afraid of how i feel about a person, a place or an event than i am actually afraid of that person, place or event. knowing that has helped me take a little more control over myself but i feel like i only have a bag of manual tools when i need a shed full of power tools. i don’t know where to start looking for a shed full of power tools. maybe this is a good place to start?

Lacey said: July 8, 201310:29 pm

This is a great thread. I’m going to try some of these coping mechanisms. I’ve been trying to get pregnant for two and a half years now, and one of the first and MOST UNHELPFUL things that people always say is “Relax and it’ll happen!” Even some medical people! There’s just nothing like being told that being anxious and stressed can stop you from getting pregnant. I feel that it is a completely perfect recipe for being even more anxious and stressed, and then feeling horribly guilty about it because you’re trying to do EVERYTHING PERFECTLY just in case it helps, and it’s just a vicious cycle. Naturally the anxiety and depression meds are contraindicated, too. I wish I had some good coping mechanisms to share, but they mostly involve getting friends and family to talk me down and self-medicating with books and music.

psocoptera said: July 9, 201312:28 pm

Has “just relax” ever in the history of ever helped anyone relax? (Whether it’s TTC, a first date, a job interview…)

For me, I don’t think it is entirely a coincidence that the two times I successfully got pregnant (after 9 months and then 4 months of trying, respectively) were when I was a) on vacation and b) just back from a vacation. Something about the interruption of routine (even if I did bring my BBT and OPKs with me, that first time…) and getting a break from certain stresses. I don’t know if this would work for you, but maybe you could try to translate “just relax” to “take more vacations”, in your head? Which still might not be something you could act on, but there are generally good real-world reasons you don’t need to feel guilty about that you can’t take more vacations, like work, and money – I just feel like it’s easier to point to that and say “self, I am taking all the vacations I possibly can” rather than “self, I am being the least stressed I possibly can”.

Lacey said: July 10, 20132:08 pm

Thanks, psocoptera! I will try to think about changing my mental message.

DEA said: July 8, 201310:52 pm

OH YAY. I was really excited when I saw this thread and I’ve read a few comments but wanted to skip down and tell a little bit of my story, because I’m just beginning to get comfortable with telling people about it.

I figured out two years ago that I have anxiety problems. But the problems had been going on since I was at LEAST 15 (I’m 27). I have what I think has been described before as “no way out” anxiety – I get in a situation and start feeling trapped, like I have no way of ever escaping and I’m going to collapse and die right here and oh my god I can’t breathe! This typically happens in quiet environments in rooms with closed doors, or in traffic (panic attacks while driving are the GREATEST). This last year, it began to affect my work, as I had trouble sitting quietly in meetings/concentrating and contributing. This resulted in me missing a lot of work and eventually being asked to resign about two months ago.

It was this last event that made me finally see a doctor. I was having panic attacks at least once a week, finding myself unable to leave the house for days at a time, and panicking when I went to the grocery store. I found a doctor and forced myself to go in for a check up (another anxiety inducing thing because they leave you just sitting in the exam room with the door closed!). And she’s put me on the generic Zoloft, which is helping immensely already.

My advice to nonanxious friends of anxious people is to not push it when your anxious friend can’t do something. It’s not that we hate you or don’t want to spend time with you; it’s that we literally, physically, cannot make ourselves do that thing right then. My anxiety has made me extremely flaky over the past few months because I’ll agree to do something and then the morning of be like “Nope, can’t do that today.” I’ve gotten a lot better about saying “No, anxiety is way too high today for me to take the train into the city to hang out at a bar with you and a bunch of strangers,” but it still sucks. And know that it sucks for me probably more than it sucks for you, because I would LOVE to hang out with my friends more often, but it’s often that the gathering is at a place I can’t get to easily (taking a train an hour down into the city, or, god forbid, driving in Chicago traffic!) and I don’t want to inflict my high-anxiety self on people after experiencing a panic situation. It sucks. I know it sucks. You don’t have to tell me it sucks.

Anyway. That’s long winded, but basically, understanding of our potential flakiness as something beyond our control is really, really helpful.

“It’s not that we hate you or don’t want to spend time with you; it’s that we literally, physically, cannot make ourselves do that thing right then.”

Yes! This!

I just wanted to echo what you said about flakiness. I have Complex PTSD, and my anxiety has been sky-high and unpredictable from day to day for the better part of the last two years. I have struggled terribly with this kind of social flakiness as a result. My solution has been to scale back drastically on the invitations that I accept and plans that I make, and to explain myself and warn friends if I think I may end up needing to cancel on them. Thankfully, my close friends have been understanding, but there were some surprising bumps along the way as I encountered some shaming and downright ableist attitudes about anxiety.

Lizzie said: July 8, 201310:54 pm

This thread is coming at a good time for me. I have generalized anxiety (not diagnosed, but a thing I struggle with). I usually control it with exercise. Thirty minutes of running, most days of the week, dramatically reduces my anxiety. Actually, anxiety is the only thing that gets me going to the gym regularly – if I think, “I have to run on the treadmill so I can look pretty,” I’ll just feel depressed about the entire enterprise, and I won’t go. If I think, “I have to run on the treadmill so I can reduce anxiety and function like a normal person,” I can justify spending the two hours it takes to get to the gym, run, stretch, shower, and go home. I can also justify spending money on basic workout gear, something that never seemed like a good investment before. Upthread, Gretchen mentioned that anxiety helped hir to quit smoking. I guess my story is similar – I knew cardiovascular exercise was an all-round good idea, but the general health reasons always seemed distant, whereas the anxiety reduction is immediate. (For me it kicked in after a couple of weeks of running, so I think it’s a similar lag time to starting a course of SSRIs.)

Anyway, I say this thread is coming at a good time because I sprained my knee slightly and haven’t run for a week. As a result my anxiety has gone through the ROOF.😦 I’ve ordered a cheap swimsuit from Amazon; not sure what to do until it arrives. But reading all these stories has been super helpful for me. Everyone has different coping mechanisms and imagery and I like to take all the stuff that resonates with me and adopt it.

Maybe some of my mental images will help y’all in return.

I like to think of my anxiety as basically mental weather. This means it’s not my fault, it’s not caused by anything particular in my life, it’s just there, and I have to get through it; the best I can do is remember to take my umbrella or wear snow boots. Once I mentioned my anxiety to my advisor, and he asked me, “What? What have you got to be anxious about?” And I replied, “Nothing at all – that’s why it’s a problem!”

Sometimes the most annoying effect of the anxiety is the “white noise” in my head. Even if I’m not engaging with the anxiety or feeding it, it still slows down my processing to the point where simple decisions take half an hour. This is particularly problematic when friends are asking me questions, either for information, or worse, asking me to make decisions. I’ll get a string of questions and feel like I have to answer them all immediately: “Where do I put the salad bowl? Do you think this pie is ready? Should we invite Joe tonight? Did we already invite that boy he likes?” If I have a lot of white noise, I’ll work extra hard to answer the four questions quickly – like a normal person – but then when the fifth question comes, “What sort of music do you think we should put on?” I’m out of mental spoons. In the past I would snap, which tended to damage friendships. I’ve gotten better at realizing when I’m working harder to act normal, and take the pressure off myself by just saying, “Hey, sorry, give me five minutes. I can’t think straight right now.”

One book that helped me a lot was ‘The Anxiety and Phobia Workbook’ by Edmund Bourne. It’s pretty comprehensive, very behaviorally focused, and I still use the breathing techniques it describes. On the other hand it’s somewhat simplified and I remember being annoyed at some of the arguments, though I can’t remember why.

Sometimes, if I’m anxious when I’m alone, I sing You’ll never walk alone to myself. Singing is calming, and that song in particular helps me.

Weather is a really good metaphor. We can’t control it, but we can have strategies to deal with it.

keelyellenmarie said: July 9, 20133:16 pm

2nding that the weather metaphor is awesome, and also chiming in to say that physical activity + meditation (I combine both in daily yoga, and supplement with additional cardio as I have time/need the energy boost) are my two most important forms of treatment for my depression AND anxiety. Unfortunately, this leaves me with the same problem as you’re having now–if illness or injury puts me out of commission for awhile, I tend to have spikes in anxiety.

My anxiety triggers secondary stress-related physical problems like super tight muscles and in extreme cases super painful muscle spasms in my upper back/neck/shoulders. I’d been given physical therapy for this because at one point it was severely limiting mobility in my neck, but what works best is having something to work out the physical stuff (exercise) AND something to help with the cognitive end (meditation/mindfulness, writing, therapy). Yoga is a lifesaver for me because it puts both together in one convenient package, but any combination that does both will work. And then the endorphins help keep the depression in check! Yay!

Monika said: July 8, 201310:54 pm

Anxiety is not (thankfully) a very large issue for me. I have minor issues with it in that I have a lot of worries and negative thoughts but I call it minor because I am almost always able to tune out and ignore those thoughts.

When I cannot tune out and I keep circling back then I have a tactic that works for me. I hesitate to mention it because it could backfire for others. I’m glad posts are being moderated because perhaps this isn’t helpful.

Anyway the thing I do is indulge my anxiety and challenge it to come up with a worst case scenario. I then plan for that scenario and roleplay it in my head, sometimes over and over. If you catch me talking to myself this is probably what I am doing. Sometimes there is even a strange transition over into fun. Like the time I played out what would happen if my office building was kidnapped by aliens. Honestly not sure what worry got that one started.

J. Preposterice said: July 8, 201311:07 pm

Hahaha TIMELY. Well. OK. I have Generalized Anxiety Disorder. When I get out of whack, I also get depression and some beginnings of OCD behaviors/thoughts (which, let me tell you, when that happened for the first time last year, I was scared half to death — OCD gets so many jokes, you guys, so many, but it can be goddamn terrifying. The first major onset of OCD symptoms came when I was out running; I came back to the house shaking and trembling and in tears over what my brain was doing, scared out of my wits and barely able to explain to Mr Hypotenuse what was wrong.) Today, I got a wild hair to shave my head, because I need a haircut but I am scared to call the hair salon. I have gone to this stylist for years; I have followed her to multiple salons; the staff at her current salon are SO nice and SO friendly and I know, I know, I KNOW that it’s totally cool that I haven’t been in for a while because I’m letting my hair grow, but somehow digging out the clippers we use to get dreadlocks off our long-haired kitty seemed like a better idea. (Mr Hypotenuse talked me out of it. I’m glad. Clippering one’s hair off is pretty much the opposite of trying to grow it out, you know?)

Coping mechanisms! So. Cognitive-behavioral therapy has been a big help to me. The biggest help in the past year was a particular trick for deal with the OCD-type thoughts: acknowledging them, letting them know I saw them happening, and that they could say whatever they wanted but I wasn’t going to let them upset me with it. “Yep. Saw you! That happened! How about that!” That ended up helping with a lot of anxious thoughts, in general, because I think _for me_ part of my anxiety is around not being heard. The screamy yammery illogical part of my brain WANTS TO BE HEARD and it will scream and talk and talk and talk and scream and yell and run in circles-scream-and-shout until it feels heard. Getting the rational part of my brain in dialogue with the anxious part tends to help me feel like I am hearing myself; the difficult part is hearing my rational brain over the screaming anxiety. Working from my therapist’s suggestions, I came up with a few things that I can, essentially, force myself to think VERY LOUDLY at myself to make myself feel heard. “YEP! SURE AM WORRIED ABOUT THAT!” and “WELP! THAT HAPPENED, OH WELL” are the two I use most often.

Dunno how many other folks might find yelling at their own brains useful, but there you have it: one of my main coping mechanisms.

Norah said: July 9, 20132:53 am

Yeah, yelling inside my own head, I do that😀.
I realise for some people it might actually be very unhelpful and turn into something ugly, but it has been such a big help to me. Just screaming over the other stuff so what I want to think is louder. Sometimes I just narrate (loudly) what I’m going to be doing, step by step. It also helps to actually do it instead of sitting in a corner paralysed).

J. Preposterice said: July 9, 201311:12 am

I do that, too! “OK! Self! We’re gonna make dinner! Stand up! Go to the kitchen! Wash the saucepot! Put fresh water in it! Put noodles in the water! Look, you’re halfway to dinner! Now get the carrots out of the fridge!”

a friend of mine recently told me something horrifying, which is that some people try to use it on actual physical illnesses that they have decided are all in the patient’s head, like fibromyalgia. that seems like an abuse of a very useful therapy, to me.

But that- what- no! No! That’s like taking bacon and using it to staunch bleeding! It’s a wonderful thing being misused.

J. Preposterice said: July 10, 201310:47 am

I was shocked and horrified, and suddenly her anti-CBT talk made a lot more sense to me. I’d always been like “but it is SO USEFUL why would anyone hate it??” before. But her experience had been with the misapplication!

Lesson learned! I will use better words when extolling the virtues of CBT in the future.

MamaCheshire said: July 10, 20139:04 pm

Yeah, no. NOT HELPFUL.

And damn it, fibromyalgia and other forms of chronic pain are actually Things In The World. (Types she who is having a flare-up of Gimpy Leg Issues due to car problems creating the need to walk more than normal.)

I had a social work classmate complaining about someone she was working with “not complying with the plan we agreed on” because apparently this plan involved “go out and socialize more!” and fibro was involved. Because I know I totally want to be the social butterfly of the season when I’m sobbing with pain, riiiiight? *headwall*

I like to think that the misapplication of CBT to stuff like this grew out of someone’s attempt to help people who are already getting correct medical treatment develop coping mechanisms and workarounds for the times when even proper doctoring can fall short. It may not be true, but thinking this is a mistake rather than a malicious thing helps me keep up my faith in the human race.🙂

Hey, thank you for bringing up the misapplication-of-CBT, J. Preposterice. Every so often, advocates of this will bomb the media with press releases about how people with myalgic encephalomyelitis (commonly known by the stupid name “chronic fatigue syndrome,” often comorbid with fibro) are helped by a combination of CBT and graded exercise therapy. The CBT doesn’t help with symptoms, and the GET is actively harmful.

I’ve mentioned this to practitioners of CBT. One seemed to think it was stupid, one said this was disrespectful to the patients, and one said that this was a completely inappropriate use of CBT. In all cases, they didn’t know anyone was using CBT this way until I told them. So it may be a few bad apples giving the rest a bad rep, but they are very, very bad apples.

Irene said: July 16, 20137:22 pm

Freud made a LOT of mistakes like this. Fortunately for him, most of the conditions people had that he mistook for hysteria/neurosis/what have you didn’t have a lot of treatment options available anyway, so he probably did less harm than he would today.

Oh, I totally yell at my own brain when it goes into the loops. I had a year plus of rage loops for good reasons, but I just couldn’t reason my way out of the loops. Therapy and major life changes helped, but mentally yelling, “YEAH, RAGE, I GET it. But I’m *REALLY* SICK of YOU! helped, too.

Shan said: July 8, 201311:08 pm

I have serious issues with anxiety, among a host of other things. I go through phases where it’s manageable in the scope of my life, and other phases where it makes it nearly impossible to do simple things. Today, for example, I had to give 30 days notice where I am living because I am moving somewhere else to finish my degree. I nearly threw up before doing so. Full on nausea and dizziness just thinking about it. I have horrible phone call anxiety. The number of people I can have a mostly-comfortable conversation on the phone WITHOUT silently berating myself through the entire thing that I’m SCREWING EVERYTHING UP and THIS PERSON IS GOING TO BE TOTALLY TURNED OFF BY MY PERSONALITY is a whopping two. Even then, those horrible self-deprecating thoughts creep in when those two people are involved on occasion, just not EVERY time.

I don’t make friends. I am quiet and anxious and excruciatingly guarded. I have tried to “slowly come out of my shell”, but every time I take a deep breath and venture out, it ends up hurting me. Horribly. Not just tiny, uncomfortable moments, but hurtful betrayals or just general meanness. So I end up crawling right back into that shell to lick my wounds and remind myself why I don’t trust or talk to people. Because “this stuff” happens. I am nearing 30 years old and I’ve had exactly four actual friends. In middle school, I had none. Not a single peer that I talked to. I firmly believe I only made it through that period of my life because I had a couple teachers that were perfectly fine with me hanging out in their classroom and talking every day after school for hours on end. In high school, I had twice as many bullies than friends. I had TWO friends during those four years, one the first two and one the third. Both of them ditched me for guys that didn’t like me and didn’t want to hang out with me. My Senior year I kept my crushing depression just below the level of “giving up” by talking to strangers on the internet. Now, nearly 10 years later, I have two friends. And yet I can’t be comfortable in these friendships. I’m guarded, I fear that I’m one action/sentence/admittance away from losing these friendships. It doesn’t help that one is already not-so-slowly drifting away from me because her girlfriend thinks she has a thing for me, is extremely controlling and abusive, and is threatened by our friendship. The other, I have had a MASSIVE crush on since we first met, long before we became close, and I am constantly worrying about whether I’m staying within the confines of a close friendship, or crossing the line into “inappropriate” and “risking the friendship.” I feel immensely guilty just sending him a single text message if I HAPPENED to send him a single text message about something else the day before. I feel guilty asking him to hang out. I feel guilty asking him to call so I can vent about something. Every single aspect of this friendship makes me feel guilty and horrible, like I’m bothering him, or wasting his time, and yet it’s the closest and easiest friendship I’ve ever had (he never acts like I’m inconveniencing him, doesn’t blow me off, is extremely honest but in a gentle way…. there’s no guessing involved, no deceit, no selfishness.) I know the ENTIRE “conflict” of this friendship is in my head, and yet I can’t stop torturing myself with it, second-guessing and deleting a harmless text, setting a limit on how soon I can ask to get together with him after we’ve just spent time together… I’m making myself miserable, and I can’t stop.

Lady Maureen said: July 9, 201312:17 pm

Are you me? Because I seriously think you are. I struggle with what you described on a daily basis. I always feel that if I’m not interesting or funny or perfect or fun that nobody likes me. And to be honest, people don’t like me because I’m guarded and standoffish, so they think I’m a snob. And I *so* know how it feels to think you’re being a burden on someone when they’re a good friend to you. It is the WORST. And everything about the second-guessing and making up the conflicts in my head is the same, too.

I wish I had advice for you, but I can relate so much to what you wrote. You are not alone. Massive e-hugs to you!

bluecandles said: July 9, 20132:44 pm

Just wanted to say, I’m there with you both. I’m slightly better because of therapy but I still have those thoughts all the time. I know all about the – “you’re not a mind reader, you can’t know” or “people are just thinking about how they are, not you” – but that doesn’t make me feel better about my social anxiety. The only person I can talk to over the phone with little anxiety is my mum, but even then sometimes I worry I’ve crossed the line (some of the anxiety comes from experiences where I’ve inadvertently made a social faux pas because I’ve never got used to the Brit way of meaning something different to what you actually say, despite being a Brit). E-hugs to both of you, too.

H.Regalis said: July 8, 201311:09 pm

I was just thinking today about when this thread would be posted! It’s like anxiety Christmas came early this year ^_^

I have a question for other anxious folks: I have social anxiety and general anxiety; I’m on meds and that keeps them manageable but not gone; I want to travel.

By travel I mean go to multiple countries over a couple years and possibly emigrate from my home country permanenty. One friend of mine who has done a lot of international traveling is very, “Go by yourself! You’ll meet so many more people that way,” whereas my thought response is, “Yeah, especially with how I can’t even order take-out food in the city I’ve lived in my entire life. I bet I’ll meet TONS of people :DDD”

How do you manage traveling all over the world and living abroad if walking around outside during the day can be scary? This is something important to me that I really want to do.

Sarah said: July 9, 201312:55 am

And from a practical standpoint, how do you manage refilling meds while traveling? I was lucky when I studied abroad I was able to get a 90-day prescription, so I did not have to try to navigate getting meds in a different country. That’s a big mental hurdle for me.

Nanani said: July 11, 20133:01 am

I think the most practical option is to have a trusted person pick up your prescription and post it to you abroad. Of course, that requires HAVING such a person, as well as staying in one place long enough to get a package like that.
I’ve never had to use this method myself but Have assisted others – it’s used a lot when, say, the visited country still hasn’t gotten around to legalizing birth control pills.

It’s also possible to get a prescription filled abroad but it’s tricky, especially if your original one needs to be translated to the other country’s language or if the meds you need aren’t legal there. So yeah, go the postal route. It’s simpler than trying to find a “legit” provider abroad.

H.Regalis said: July 11, 201312:10 pm

How risky is that, if the meds are illegal? Anyone know anyone who got busted for it? Pretty sure all my meds are legal, but that would be my major concern.

When trying to send OTC medications to a friend of mine in Japan, we found the biggest problem was actually that they couldn’t tell us if it was legal because they didn’t know what half the stuff we were asking about WAS. (Benadryl baffled them. The Far East is big on just drinking loads of tea and suffering through your hay fever, apparently.) Unless you have a prescription for hash or cocaine, the odds that your medication will be outright illegal anywhere is pretty low. The bigger problem is likely to be that what you need isn’t marketed where you are, and isn’t easily available.

It depends on where you are. AFAIK, things like antidepressants aren’t considered illegal anywhere, so if worse comes to worst, you can have someone pick it up in the US and send it to where you’re going to be. Things like tranquilizers may be trickier, but most places are all right with you bringing or having sent in a personal supply of things unavailable in that area.

If all else fails, find the nearest university that has an international exchange program. They WILL know where an English-language clinic is, or be able to find you an interpreter.

H.Regalis said: July 12, 201310:39 am

What I’m wondering about are amphetamines and tranquilizers. I have a friend who’s got ADHD and has written off going to a number of countries with me because he doesn’t think he can bring his meds, and another friend who does want to travel with me but needs to take tranquilizers for her anxiety. I don’t want either of them to end up in jail somewhere because we didn’t understand the laws correctly.

I am not a lawyer, but with prescription drugs, it’s generally the case that other countries are more permissive about prescription drugs that might potentially be “fun” than the US and western Europe — the restrictions on things like tranquilizers are fewer in, say, India, or Mexico, where you may be able to get them directly from a pharmacist without going through a doctor. In places like the EU or Japan where the restrictions may be tighter, there is generally an exemption for small amounts of Rx medications, brought in by a traveler who has a legitimate prescription from a place where they are available.

Mer05 said: July 9, 20134:14 am

Hi, H.Regalis! Unfortunately, I’ve never succeeded in leaving my anxiety home…
And maybe I’m doing it wrong, but I’ve traveled solo (domestic and international) without ‘meeting people’ in the easy, organic way that one hears about. But I enjoy looking at their museums, so it works for me?

For my fear of looking like an idiot, I try to remember that I will never see this particular desk clerk/bartender/passerby again. The relative anonymity helps.

I also plan for my tolerance levels, which means early nights and sporadic time spent sitting around reading a book, and not trying to do All The Things. For food specifically, I buy postcards to fill out during sit-down meals, and shoot for not-too-fancy locations (or takeout).

My trips definitely end up being more ‘new place, same me’ than ‘wild adventure!’ – but on balance I have fun and have decided they’re worth doing.

Katie S said: July 10, 20133:16 pm

“For my fear of looking like an idiot, I try to remember that I will never see this particular desk clerk/bartender/passerby again. The relative anonymity helps.”

Very much this. I take a lot more social risks with people I don’t expect to see again, and actually end up being quite outgoing and friendly, whereas when I’m meeting new people in a work or family context it’s much harder because I am afraid that any mistake I make will haunt me forever.

The other great thing about travel is that you are not expected to know all the rules. This is especially true if you go somewhere where you are obviously a foreigner (e.g. Caucasian in Japan). Read Culture Shock or something like it, learn to say “please” and “thank you” in the local language, and you will already exceed most people’s expectations of a foreign traveller.

My first trip to Japan involved winging it with a lot of my accommodations. I don’t usually do that anymore, but it was pretty confidence-inspiring to just walk in and book a hotel room in a foreign language. The only trouble was when we were in a town where there was a festival going on that we hadn’t known about, so almost everything was booked. The local visitor’s office was extremely helpful and called around to find us a place to stay. Relying on help from other people is definitely outside my comfort zone, but it was a good feeling to do that as a traveller and put some trust in my own abilities and in other people’s kindness.

If you think of travel as a kind of social sandbox where the consequences of your mistakes won’t haunt you forever, it can be very freeing. Go with a genuine curiosity, an open mind and heart, and make mistakes – it’s okay.

Ellen said: July 9, 20138:48 am

I have no tips about living abroad, but I did take a rail trip through four countries while my anxiety was acute so I have some strategies that worked for me.

I started small, with countries where either I or my travel buddy spoke the language or where English was widely spoken (and my ‘spoke the language’, I mean ‘could navigate a menu’, not ‘fluent and kick-ass’). I also travelled with a close friend I trusted, briefed her on what my panic attacks were like, carried phone numbers of safe people in a few places, took medication as needed and went for a short period overall (two weeks). It gave me the confidence to try something tougher the next time.

The nice thing about being a foreigner travelling abroad is that you get a free pass on not knowing what the local customs are. I’ve found that as long as you’re polite and ask questions/show an interest in learning, people are happy to help you out. Lots of native folk like showing their culture/customs off to nice travellers.

When I travelled, I spent a lot of time alone. I’m not convinced that this is necessarily a bad thing! I also met people, by staying in hostels or going to clubs by myself. So basically, I gave myself a free pass to spend an afternoon at a museum by myself or spend a whole day in the library reading if need be, but I also went out and pushed myself to meet people.

Full disclosure: My anxiety leans heavily towards the “OMG people will see me doing things wrong and make fun of me/obsessing over logistics” variety. But for some reason, the mental shift of being a stranger in a strange land got me over that hump. No one *expected* me to know the logistics, so it was okay if I fumbled. And for some reason, I find it easier to strike up conversations with fellow travellers than random strangers back home.

This is my experience, too. When I’m at home, I really worry about “not fitting in” or committing some minor faux pas… as if taking a wrong turn, or buying the wrong thing at the store, or forgetting the word for something is some kind of punishable offense. My subconscious is big on things I “should” know and is basically convinced that I am too smart to ever make mistakes, and so if (when) mistakes *do* happen it’s clearly because I wasn’t trying hard enough or wasn’t paying attention and OMG cue Jerkbrain Shame Spiral Forever.

But traveling makes my subconscious let up on all that stuff, for whatever reason. It’s a free pass to just be a tourist, ask questions, get lost. I wish I could figure out how to bring that “Haha, sorry, I know this is a dumb question but I’m not from here!” attitude back home with me. I guess I could either (a) become a nomad or (b) start pretending to be a space alien who crash-landed on this planet yesterday.

Obviously YMMV, but I just wanted to say, depending on how your specific anxiety works it might turn out to be okay. It’s pretty common for me to have days when I can’t make it to the grocery store (and making a phone call is right out on most days), yet I spent a very pleasant month in Japan by myself, and actually spent less time there worrying about random stuff (to be fair, possibly because my brain was being kept fully-occupied by real stuff, like remembering which kanji meant “this rice ball has icky meat in” and which kanji was “this rice ball is full of delicious pickled plum”).

JC (Sara) said: July 10, 201312:03 am

Generalised anxiety, not diagnosed. So that caveat out of the way, I’ve travelled quite a bit, often solo. I think a useful thing is to be aware of the kinds of things that can trigger your anxiety. One of my anxieties is knowing where I will sleep so I make sure I book all my accomodation before going. I also make sure I carry enough credit with me that if for some reason my accomodation doesn’t work out (cockroaches, mysterious bad smells, the zombie apocalypse ground zero just happens to be at my hotel) I could walk into a big expensive hotel and check in if I needed to. I’ve never had to, but you know, it’s there as a back up just in case. I’m also terrified of not being understood so I will usually learn the basics of a foreign language before going (4 and counting) but I will admit to this being a little excessive and usually entirely unnecessary.

In terms of solo dining, there’s lots of opportunities for buying groceries and making your own picnic style food. In Europe for example there is always the bread and cheese (yummy cheese!) option if all else fails.

I also usually give myself something to do if I’m eating at a restaurant. I take a journal so I can write down things about my trip, write postcards, or even just read a book. I’ve never been anywhere where my solo dining has caused any comment or even a suspicious look. With my anxiety I can often bring myself to do something if I have a PURPOSE! So my purpose when eating out is to journal my experience of the day. The fact that I’m also eating out is a small side issue which I won’t allow my brain to spend too much time thinking about.

I feel anxious about going out sometimes but I usually focus on the thing I’m wanting to see (usually art or architecture in my case) and the fact that I have travelled half way round the world to see it and therefore nothing will stop me from doing so (and I visualise giving the finger to my anxiety which helps).

That all works if you’re not particularly interested in meeting other people (I’m an introvert so that works for me).

If you do want to meet people, the best place I found when travelling was to stay at a youth hostel. There’s usually enough solo travellers and pretty free floating social activities that it’s relatively easy to at least have small conversations with people. The fact that you’ll never see them again can be a big plus.

A big old YMMV on all this.

Astral said: July 10, 20139:09 pm

I have some social and phone anxiety, but a lot of this stems from internalization of unhealthy admonitions growing up “You should just know that,” “It’s your own fault if you don’t/didn’t…” “What will people think?” But I’m a huge solo traveler (Ok, in all honestly partly because I think “Who would ever want to travel with ME to all the weird places I want to go?” Jerkbrain talking, because one of my friends really does want to go to one of these places! And my ex also had offbeat travel interests which appealed to me! Also have done several study abroad/backpacker bus where I don’t know people beforehand but form enduring friendships during) Anyway, in other countries, I’m not supposed to know basic stuff; it’s not always, or even usually, my fault if something goes wrong; and what these people think will have little to no bearing on my future.

And with HostelBookers and Hostelworld, I can make reservations online (no phone!) and find hostels and cheap hotels that suit my needs at the moment. And the people who are also staying there have the same weird travel interests as me! And like others above, I am much better at making anonymous connections. Then you find out that most people have quirky issues, too. Especially if you end up becoming friends or even just FB-friending them. You can keep to yourself if you want, or strike up a conversation cooking, or announce to everyone sitting in the common space that you’re going to go to x place in so many minutes if anyone wants to join, or get convinced by the rowdier ones to go out to the club.

And when I really want to go somewhere off the beaten path and do have to use the phone in a language I’m learning, I’m motivated more by my desire to not have to wander the streets all night. I just rehearse the call for a while and then do some self-care after to calm the adrenaline.

Mer05 said: July 10, 201311:45 pm

“Who would ever want to travel with ME to all the weird places I want to go?” Ditto this! When I was first mulling a major trip, one friend of mine was All In… before she bought a racing bike and a new porch. I booked the tour anyway – and she still hasn’t made it over. Do not wait for someone else to want to go to all your weird places.

One thing that is worth highlighting: most travel problems can be solved if you can throw money or time at them. For me it’s important to know that if Plan A falls through, there are taxis, hotels, and airlines available, for a price. (I once spent all night in a London tube station en route to Paris. No regrets, but hopefully never again.)

Another out-of-comfort-zone suggestion: when in a foreign country, try a third cuisine. I’ve had good luck with Mediterranean (falafel, kebap) and my favorite overall was an Ethiopian restaurant, because they assumed you were totally unfamiliar with the food and how to eat it unless you said otherwise.

I hope it’s not out of line to request stories, but I was frantically scanning these comments looking for a “…and here’s how I decided my issues were worth getting therapy for” story or two.

Ever since I learned what anxiety is, I’ve suspected I suffer from…something. Maybe. I have known that some of my “bad habits” might be more accurately called “compulsions”, and that perhaps my “laziness” and “apathy” might actually be “anxiety”, but… I just don’t know. Anxiety issues are really well-discussed on the ‘net, to the point where it feels like the fashionable new thing to self-diagnose with (like Aspergers, and ADD before that). I worry that my, um, bad habits and laziness are just that–normal, regular things that don’t require therapy and that I’m just self-dxing, because having a name for my quirks would alleviate my guilt at not being able to stop my bad habits, or make me feel better about quitting pretty much everything I’ve ever started.

Anyway, TL;DR–how did people with diagnosed anxiety make the leap from “I’m fine…I hope…” to “this probably isn’t normal, I’m going to get help.”? And how on earth do you go about getting “help”? Who do you call? What do you say? (the more I go on, the more the above discussed workarounds start sounding eerily resonant)

Mary said: July 9, 20135:25 am

Here’s another way to think about it: “What if I don’t really have back problems? What if I just have really bad posture? I can’t go to the doctors because if it turns out that I don’t really have a treatable back problem, just bad posture, then …” Then what? You’ve been trying to “change your posture” by yourself for 15 years, so regardless of whether the “real” problem is treatable back pain or bad posture, a few sessions with a physiotherapist showing you exercises that’ll make it easier to change your posture could be helpful.

And actually, the line between “treatable back problem” and “bad posture” is never that clear cut, and the same is true for the line between “laziness / apathy” and “anxiety / depression / other mental health problem”. Therapists are like physiotherapists or dietitians: some people they see have a formal diagnosis, but many of them fall somewhere on a scale of “some habits I would like to change and need some help to change”.

I think if you’re feeling like you’re not doing so well on your own, that’s a good time to look for help. If you’re in the UK, http://www.itsgoodtotalk.org.uk/ is a good place to start, and even if you’re not in the UK you could look at their links on “What is therapy?” and “Types of therapy” just to start thinking about it. Try not to think, “Am I diagnosable enough to be entitled to / allowed to do this?” – instead, think, “Does this sound like it would be useful to me? Would it be good to have a space in the week to concentrate on this stuff with someone whose job is to help me?” If the answer to the last two questions is yes, then keep going forward. Maybe start thinking about which particular types of therapy appeal to you, and then start finding out how people access therapy in your area.

(Caveat: there are going to be some types of therapy and medication where you have to have the diagnosis to access treatment, but I promise you don’t need to be sure that you’re officially diagnosable simply to start exploring. I hope this is helpful! good luck.)

Personally, I had to hit near-rock bottom before I dragged my ass to therapy. It was in the middle of an IM argument with a partner during the workday, and I found myself totally unable to control myself physically (shaking, crying, wanting to vomit, etc.). I’d done some research earlier on trying to find therapists, but hadn’t been able to bring myself to make the phone call.

I got up in the middle of that conversation, went outside, walked down the hill, sat on the stump and made the phone call. And it has quite honestly been *life-changing*. I can’t recommend good therapy enough.

My therapist would say that the criteria for getting treatment for something is: “Is this thought pattern/behavior negatively affecting my quality of life?” If it’s a minor annoyance, but it doesn’t really make your life hell, then maybe not. If so, then you should get it treated.

I highly recommend that everyone at least explore the option of therapy. I grew up with a concept of therapy as a Thing Only Crazy People Did, and even an occasional threat (“If you don’t stop acting this way, we’re going to take you to see a shrink, I don’t even know how to deal with you anymore”). So I had to let my depression issues get pretty bad before I landed there. It wasn’t to the point of being suicidal, but I was fighting constantly with my partner, I felt out of control of my life, I was miserable every day. At some point he said to me that he didn’t know how much longer he could stay with me and bear the brunt of my unresolved issues. It was kind of a wake-up call.

Anyhow, I had a year of CBT and it has honestly improved the quality of my life in a real and noticeable way (not to mention probably saved that relationship). Plus I have much better tools to manage stuff going forward.

My only regret is that I didn’t get my butt to therapy half a lifetime ago. I wish we didn’t have this cultural narrative where it’s a method of last resort — I think most people could benefit from at least the occasional check-up, the same way you’d go in for an annual physical.

Welp. I figured it out in college when I started puking routinely before I had to go take exams. I did something about it years later when I had a panic attack that lasted two solid days, and prevented me from eating, sleeping, or doing anything more useful than curling up in a ball and sobbing hysterically. I had no health insurance and no job at the time, so what I actually did about it was hike three miles or so to the local ER, where they were legally obligated to treat me. And I do mean hike — the roommate with the car was at work already.

When I told the ER people that I walked there under my own power, they looked at me like I had grown a second head. I am a stubborn cuss, no matter what kind of wreck I look like.

By the time I did that I had an excellent idea of what was actually wrong, which I got from many years of self-analysis and some dabbling in recreational drugs. (I do NOT recommend this. It was a COMPLETE ACCIDENT that the data I got from it turned out to be useful. I just believe in making the best of bad situations, and stupid ideas.) I told them that I had symptoms A, B, C from the checklist, and additionally also some Q, 23, and fish, because I don’t present anything normally, and that I had read about this particular list of drugs that are used for it, could we please start at the top and work our way down?

We made a lot of thrilling discoveries, like that Ativan inexplicably makes me hurl, and that SSRIs are thoroughly no bueno for my brain. I think they figured no junkie could conceivably think this was a good way to malinger for fun drugs, so it would be all right to send me home with large amounts of Xanax, which did in fact help a lot. (I also made it quite clear that I could not pay for any of this, at any point, and none of them cared. One of the residents actually apologized that she couldn’t get the dispensary to give me the Xanax for free, and had to send me to Walgreen for a bottle of generics.) I had much worse luck trying to find a PCP and/or therapist that didn’t make me worse very quickly, but then I moved across the country to civilization and discovered that some people actually listen to you when you talk.

Caitlin said: July 8, 201311:31 pm

For the last few days, I’ve been having an internal discussion about writing in to Captain Awkward about my anxiety issues. I can’t quite cope with writing it all down right now, but I just wanted to say thank you for hosting this thread, it feels wonderful to know that I am not entirely alone, and that others have not only similar issues, but have discovered ways to work with them. The last several days have been increasingly difficult for me, to the point that I finally admitted it to my parents, who encouraged me to go get help.

However. Anxiety. I don’t know where to start in getting help. I have insurance, but I don’t have a primary care physician, and I am overwhelmed by the number of choices. I’m 99.9% sure I have serious depression and anxiety, and I need therapy/medication, but where do I start to get this help? Can I just go to a regular doctor and say “sometimes I can’t make decisions because everything is terrifying and my heart feels like it’s going to burst and I want to die?” or “so, i think i have anxiety and depression and my friends with similar issues say welbutrin saved their life, maybe can i have that?” I have a PPO, would I be better off seeking out a specialist immediately?

I was seeing a therapist for grad school related reasons, but it was talking to my GP that got me started on my course of medication and also got me some more intensive therapy at the time when things were really rough. At the very least, any GP should be able to refer you to some services that are available.

One of the extra fun things about these sorts of medication is that they don’t work immediately, and they don’t work the same way for everyone, so if you end up with a doctor who thinks you need them, it may be better to have one who understands exactly what sorts of symptoms you are having.

For years, even when I saw a therapist I didn’t talk about stuff like self harming and suicidal imagery, because I was JUST TO EMBARRASSED. Because even when talking to someone whose job it was to help people who are having difficulties with day to day living and emotions, I wanted to make a good impression and not come across as a screw up.

If you can see a specialist without a referral, there’s a database on the Psychology Today website that lets you sort by location, specialties, and what insurance they carry. That’s where I’ve started.

J. Preposterice said: July 9, 201311:18 am

if your PPO lets you self-refer, go ahead & find a psychiatrist on your own. I looked up the ones my insurance provider covered and picked the one closest to my work (that was all I was up to handling at the time — if I’d done more research I would’ve ended up in analysis paralysis). The practice I ended up with turned out to be a multi-provider one that has both psychiatrists and therapists on staff, so the psychiatrist I saw (the one with the first available appointment) was able to send me to one of their therapists that he thought would be sensitive to my particular issues because he knows her work really well.

That was all sheer luck; a lot of people need to look around more to find psychiatrists and/or therapists they click with or who take them seriously. But it did work out, and it all started with a self-referral.

For years I got my meds from my GP. It is better to have a therapist in the loop but you can talk to your GP about this and get something.

In my area, the county is doing a thing where all doctors of all kinds have to do a depression screening. It was tiresome when I had to take the screening test five times in a week, but it points out how any doctor of any kind should be able to get you into mental health care.

One amazing thing is that just making an appointment with your regular doc to say you think you might be depressed, help…. That call can start to turn you around. It is positive action for healing.

If you have no PCP, you’re starting from scratch, and you’ll just have to call around to whoever takes your insurance. When I needed a doctor’s appointment and was unable to handle making it myself, I gave my best friend all of the documents she would need to commit all-out identity theft and asked her to do it for me. She did, which is why she’s my best friend in the first place.🙂 If you have someone you can trust to do that for you, try it?

I haven’t had a chance to read the other comments yet, but I’m sure they are awesome and valuable. Thanks so much for this thread Captain.

So, I’ve had chronic anxiety and secondary depression for… as long as I can remember, really. I’m talking Type A perfectionism manifesting in panic attacks in middle school. A constant sense of dread like I have forgotten something terribly important and some mysterious authority figure is going to come along and punish me.

For the last six months or so I’ve been getting therapy and it’s been a lot better, but this week has been tough. One night last week, I took a medication which accidentally triggered the worst anxiety episode I can ever remember, and I sat awake all night, twitching every time my boyfriend breathed loudly or brushed against me, crying silently, feeling like I was going to die. It was awful to experience that same old violation of trust, feeling like my mind had no integrity, not knowing which of my feelings or responses was reasonable or unreasonable.

For me, anxiety is tiring, boringly repetitive, frustrating, a dampener, and something I fight against as I go about the daily business of living. It’s very much internalised and there are probably people very close to me who have no idea that I struggle as much as I do. I can put on a very good front that I am fine while I am internally feeling so anxious that it feels like dying.

For me, accepting that I was never going to find a “cure”, that anxiety is an autonomic response largely based around body type, that it plateaus with exposure to an anxious-making situation, helps. Yoga helps. Deep breathing helps. Eating food that feels good on a regular schedule helps. Getting enough sleep helps. Acknowledging and sitting quietly with anxious feelings for a short time can help. Some sort of structure of work and play helps. Journaling, and trying to notice what I am thinking and feeling at the start of an anxious cycle rather than when I am well and truly in it, helps. Recognising when I want some alone time away from loud noises, other people and the need to be social, helps.

I’ve fallen in love and started seeing someone recently, and the emotional effect as well as the effect on my routine has been intense at times, fine at others. He knows about my mental health issues and he’s great about it. A kiss and a cuddle helps. The thought of his seeing other people, the thought of us breaking up, any indication that we are in any way wrong for each other, does not help. There’s a lot of bringing myself back to the moment and reminding myself not to borrow trouble or catastrophise.

I think the major realisation that has helped me deal with my anxiety, as with dealing with all moods, is that I’ve realised it’s not ‘true’ and I don’t need to ‘obey’ it. It’s a feeling and I feel my feelings, but they’re not TRUTH or CHOICES and of themselves, can’t control my life. I can be feeling anxious and like I want to go home and crawl into bed and still finish my day’s work, or speak to the check-out chick, or go travelling internationally on a work trip. I can feel terrified beyond belief and still set up a small business, or run a marathon, or whatever it is. Often it means that I accept that I will do it “inelegantly” – after every single marathon-training session, I would cry in front of my running group due to the psychological pressure and stress, and they knew to just expect it and that it didn’t mean anything except that I often needed to cry. The thought of anxiety as something which impacts my MOOD but not my LIFE CHOICES makes it far less frustrating and debilitating.

This thread is making me think about my experience with and responses to anxiety in a way that I never have before, so forgive me while I keep on talkin’.

When I am anxious, being in a messy environment doesn’t work for me at all. Being unable to find keys or important paperwork doesn’t work and makes me feel even more out of control. Often, I use anxious energy to tackle chores and do the dishes – there’s something about the repetitive motion of dish-washing plus having my hands in warm water that helps. Then, when I am less anxious, I have a cleaner house – this feels like turning lemons into lemonade. (Although I suppose that taken to a manic extreme, it could be unhelpful.)

Listening to certain types of music can help – soft female or mellow male voices, acoustic or classical, no heavy dancing beats. Reading fanfic or something similarly absorbing and to a degree “mindless” can help. Sex for one can sometimes help. Going for a walk can help. Texting a friend can help. When I am feeling very bad, actually telling someone that I am having anxiety and asking them to help me with what I need can help. “Hey , I am feeling anxious at the moment, can you text me something nice and reassuring? / sit with me for a moment / give me a cuddle? Thanks.”

This goes without saying and is the same across all mental illness or other illnesses or challenges: anxiety isn’t weakness. I sometimes feel like it makes me a boring, serious type of person, compared to other apparently young and carefree people my age. But it’s not a character flaw or a weakness, it’s a brain glitch that makes some facets of my life harder than they would otherwise be, and it’s something that I use my considerable strength, humour, self-love and wisdom to live with and work around, to live the life I want.

Nymerias said: July 9, 201311:45 am

Wow, are you me? I relate to this SO much, right down to the new partner feelings. A few weeks ago I was having a terrible episode triggered by my boyfriend canceling plans, and after crying to my mom a whole lot about it, she told me not to “borrow trouble.” It’s actually kind of eerie how much this comment hit home for me!

There was a CA thread very recently about feeling lonely / anxious in a relationship. Reading through the Captain’s response and others’ comments, as well as thinking about my own strategies for what to do if jerk!brain+romance=AAARGHHHHH!, was really helpful. I’d highly recommend having a look a few threads back if you haven’t seen it already. Good luck with managing your new partner feelings. I’ve talked to non-anxious friends who still said that navigating new relationships can be a totally stressful time because of starting to manage expectations / not wanting to be “pushing too hard” / the daily business of two people smooshing even minor parts of their lives together.

Phospher said: July 9, 20133:25 pm

“A constant sense of dread like I have forgotten something terribly important and some mysterious authority figure is going to come along and punish me. ”

Aaaaargh, yes. Yes, that!

XtinaS said: July 9, 201312:26 am

I have generalised anxiety stuff, definitely. I have certain things that are hard for me, like anything to do with authority figures, and certain things I cannot do. For example, while I technically can use the phone, I need to be drugged, or block out an hour of time after to shake in the corner.

I was in a long-distance relationship for 7 years, and we had weekly phonedates, that my partner initiated, because I would not pick up the phone.

I also have weirdly specific claustrophobia. Like, being in an elevator is fine, and living in New York hasn’t yet bothered me in that direction, but there are times when I can’t stay on a subway the entire way to a place, because it sometimes gets so crowded that I literally have to get off the train and stare in a corner for a few minutes.

Or christ, if I try to put on clothing and I get trapped, I freak *all the way out*. So specific; so infrequent. I had to try on new bras the other day due to a size change, and nnnrgh this one bra wouldn’t go on easily, and then when I knew that and tried to reverse the process it wouldn’t come off, and aaa no no no. (Spoiler: it came off, I didn’t do damage to it or flee the premises.)

(Also, I dunno, does paranoia fit in with the “anxiety” theme? Because I’ve been paranoid all my life, such that it’s sort of normal now to assume that people are watching me all the time. I’m told that’s not how most people feel, but enh, a lot of people aren’t cat people, so whatever.)

bokhyllen said: July 9, 20134:56 am

Oh man, I feel you on the trapped-in-clothing thing. I think I’ve actually ripped clothes I was trying on before because I freaked out so bad and I feel awful about it (I… pretty much just fled the premises, I didn’t know what to do and was scared of talking to a shop person).

For me, paranoia feels like a manifestation of anxiety. But I really like to fit things into categories, because understanding something is the first step in figuring out whether I need to do something about (whatever it is).

Lindsay said: July 9, 201312:26 am

This thread is perfect timing for me because I’ve just recently (very recently) come to realize that I’ve been struggling with generalized anxiety since I was 11 (I’m almost 21 now). A lot of my problems center around social interaction, where I’m painfully aware of every little mistake I make in those interactions and become convinced that people hate me and/or think I’m stupid because I said dumb thing X. But in general, it’s what my friend calls “free-floating baseless fear.” At night I either wait until I’m completely exhausted to go to bed, or I watch Netflix because if I let my mind wander I’ll never get to sleep, because my brain will find Something To Worry About. Sometimes it feels like I’m being eaten up by all my worries, and so a coping tactic I’ve been trying to use is to think of the *worst* thing that could happen as a result of a particular situation, and then decide if that thing is really all that bad. Usually it’s not. This doesn’t work all the time, and probably isn’t for everyone, but I’ve found that it’s helped me to dismiss a lot of “dumb” fears because I know I can handle even the worst possible consequences.

Also, I’ve been trying to pinpoint what triggers anxiety/panic attacks in me so that I can avoid those things. It makes me feel more in control, same as when I make lists so I know I won’t forget anything.

RC said: July 9, 201312:28 am

I’ve never been diagnosed with anything but I have a lot of anxiety about touching. Perhaps some people here have some advice on this. I don’t like being touched by strangers, even shaking hands, and it actually hurts sometimes when I am touched without warning. I sometimes have to go somewhere private to calm down after a coworker (who I assume is trying to be friendly) pinches my arm while walking past, or comes up behind me and claps their hands on my shoulders. Its kind of difficult to tell people about this without sounding like I’m completely nuts.

This is a problem with my dating life since when people go, “I know a guy that you would really like!” or “That guy over there thinks you’re cute!” all I can think about is A STRANGER TOUCHING ME and I do everything that I can to ensure that this person and I never meet. Its not that I don’t want to be touched (intimately or casually), but I have to feel very comfortable with a person before I can come into contact with him or her and not feel like my skin is trying to crawl off of my body. Is this even an anxiety problem? I don’t know.

Lousie Dee said: July 9, 20136:17 am

It could be an anxiety thing, it may not be? Does it matter? It clearly makes you uncomfortable when people you’re not comfortable with, so you shouldn’t have to put up with it. You have every right to tell people not to touch you, and you do not have to tell them why.

JenniferP said: July 9, 20136:24 am

Dear RC, have you talked to your coworker? Friendly intentions don’t mean that unwanted work touching is ok. “I know you are trying to be friendly, but being touched makes me very anxious and upset. I’d like you to stop, please. thank you.”

If this person were to keep touching you after a simple request like that, it’s for sure an HR issue. Probably, though, s/he will say “I am so sorry, I didn’t know!” and stop doing it 90% of the time (might need a few reminders).

Katie S said: July 10, 20139:26 pm

I have this problem, and I have anxiety. I’m not sure either whether the two are related, but it’s certainly possible. It’s also possible that it’s a cultural thing I absorbed (spending a lot of time not in the US), but it makes me extremely uncomfortable when people touch me, especially unexpectedly. I had to have this talk with my boss, who was a shoulder-patting kind of guy (which I HATE and also think is particularly inappropriate for a middle-aged male manager to do to a young female subordinate in a workplace situation), and I kinda bumbled through a “I’m just weird, it’s not you it’s me, but please stop” conversation.

Have you seen the Boundary Circles graph? This really helped me visualize my problem. My in-laws are huggers-and-kissers, and their friends (strangers to me) are as well, and they seem to think that this preference is transitive – i.e. I have been kissed by strangers because they were friends of my mother-in-law. An example is here:

For me, my hug circle is very small, and it takes a long time for me to let someone in. Even my handshake circle is a little smaller and has a higher barrier to entry than most people’s. My in-laws have a very large hug circle, but everyone (except my husband) in their hug circle is in my stranger circle, therefore the transitive property does not apply!

I just wish I had the guts to explain this to them, but I hope it might help you.

I have kinda similar issues with people touching me. Some days are worse than others, but when someone touches me unexpectedly it makes me really anxious and self-conscious. I work with kids, and one four year old girl was telling me how pretty my skirt was while stroking my leg. Completely harmless, mostly affectionate. But I skittered across the room to get away from her. Crowds where people keep bumping into me? I want to climb the walls and scream and cry and punch people. Even people being in my personal space (generally, if I can touch you, you’re in my space) can freak me out. I’ve always thought it was because I grew up in a rural area and just wasn’t used to crowds. And that might be part of it, but I’ve lived in cities off and on for 6 years now, and it only gets worse.

I also think for me, it’s because my dominant sense is touch. Touching anything or anyone affects me quite strongly. Hugs from close friends and family are the best thing ever! But strangers and people I don’t trust being really close to me or touching me feels threatening and like a violation.

Ugh, anxiety. I’m currently in therapy/on meds for my anxiety. I’ve (thankfully) never had a panic attack, but I get the paralysis/no sleep/chronic acid reflux/nausea/IBS flare ups.

A thing that therapy taught me to do, when I’m stuck in an anxiety loop (usually about work, when I am not at work), is to write down why I’m anxious, write down the worst case scenario, then write down the evidence for and against. This means the non jerkbrain part of my brain kicks in and gives me all this evidence over why I shouldn’t be worrying. Or why I should do X.

Sometimes it doesn’t work, but sometimes it does. It’s been a great help for me when it comes to realising that some of the things I worry about aren’t actually my problem/I’ve done all I can and it’s not my responsibility, which was such an issue for me.

If I tell people I suffer from anxiety I mostly get ‘but you don’t seem anxious, you seem really together!’ which, while I get what they’re trying to say, is the least helpful, because I feel bad enough about getting treatment/feel like a big faker who is faking/it’s not that bad as it is.

But I’m getting better, I’m starting to be able to talk to strangers for a short period of time without obsessing before/after for days, which is nice🙂

Er…I’m not sure I’ve said anything helpful? But I’m going to post because fuck you, anxiety.

zucca said: July 9, 20132:40 am

I cannot sing the praises of the medication/therapy combo highly enough – two years ago I was so anxious I couldn’t leave the house without throwing up, and now I have pretty much no anxiety. I can drive and live alone and do social things with only minor workarounds for anxiety management! It is seriously amazing.

I use Pristiq, which had some pretty awful side effects for the first week and didn’t start working for two months, but once it did it was basically a steady and constant improvement. Once I could leave the house without having a nervous breakdown I started therapy, too, both general talk therapy and cognitive behavioural therapy.

Overall I think the CBT was the more helpful, because it gave me a sense of control over my own feelings. I used to describe anxiety as a hag on my back, constantly digging her long claws into me, but no matter how fast I ran she came with me. CBT made me feel less helpless, and I still use those thought-monitoring techniques to diffuse anxiety now.

I highly recommend this website – https://moodgym.anu.edu.au/welcome. It teaches you CBT techniques – it’s free, from a reputable university, and you can do it from the safety of your own bed. It says it’s mostly for depression, but I found it super super helpful for anxiety.

I have Generalised Anxiety Disorder. I think that just means they don’t have a very specific name for your fear issues. Kind of like IBS for bowel issues where they just don’t know exactly what it is. My fears have nothing to do with social stuff (amazingly; I am also autistic).

The fear is kind of like an ever present background droning, that sometimes flares up badly. It also likes to have a focus, or a topic, but it doesn’t always get one. One of these can be some traditional horror stuff, like scary clowns, the dark in general, the woman from Ringu, etc. For days, weeks, months, or sometimes years (there are gradations), after seeing a film like that, I will be too afraid to move from a corner of the room where I can see everything (with all the lights on). Too afraid to go to the bathroom or brush my teeth or go to bed (without someone else there). The only way I could get to sleep was basically just dropping from exhaustion. Sometimes I peed in bed because I was too afraid to move to get out from under the covers, let alone get to the toilet. And knowing rationally that none of the horror stuff is real really doesn’t make a difference. When you’re 5 years old this is kind of cute. When you’re 12 it becomes seriously worrying. When you’re 30 you have a major problem. When I was little I used to imagine what my perfect home would look like: a small room with no corners or dark spots, with just one mattress in it on the floor so there’s no space beneath it. And no other rooms or furniture: I’d get fluids and stuff in and out of my body through tubes.

Another focus can be medical issues. I’ll have a cramp and I’ll fear it’s something serious. I’ll remember my grandfather’s and my mother’s high blood pressure issues and I’ll be afraid for ages that I have high blood pressure and might have a heartattack. The fear is slightly different there than with horror stuff, and it’s less of an immediate problem and more of a long-time-wear problem.

It took me some 15 years to get to a place where I could manage the fear well enough to just live. This is mostly because I received little to no outside help. When I was 12, I would cry in bed at night at the thought that I would never live without my parents because they’d have to come into the toilet with me so I could go until the end of time. In the years after that, on my request my mom and me visited a couple of psychologists and psychiatrists to try and help with the issue. One of them could see the problem but did not think there was anything he could do (he could not prescribve medication). Another one told me it was completely normal to feel fear in these situations and I had nothing to worry about. After that one I felt so dejected that I just kind of gave up. No one wanted to prescribe meds to a 16-year-old, apparently, and it didn’t seem like there was any other therapy either. (Of course there was, and I don’t know what kind of bozos we met, but anyway).

I had to try to find solutions on my own, because there really wasn’t much else to do. This did teach me some valuable lessons: it may be really slow but eventually I could get to a point where I really had the fear managed, and I could do it on my own; and it may not have been my preference then, but I could do this without medication (I had been afraid it would be impossible).

What I do now is a combination of avoiding triggers (horror films and books of a certain kind, any information on medical or health issues and diseases that I don’t strictly need), and thought exercises. One of these is distraction, which I have gotten extremely good at. In general I’ve had to learn how to direct and focus my own thoughts more. I also do stuff that I later learned is more or less what they do in certain therapies for fear disorders, only adapted to someone doing it on their own.

It took me a very, very long time to start avoiding triggers. In part because I really love horror, and reading about medical stuff. Mostly though it’s because the fear doesn’t go away without a focus, it’s just different. In some ways it is far more unpleasant without a focus, because there is less for me to deal with, and because if it lasts a long time and has no focus, I tend to get a period of bad depression afterwards. All in all things did get a lot better when I started avoiding them, though. I got fewer and fewer bad flare-ups, and now it’s been almost a decade since I had one that lasted more than a day, and that only happens maybe once a year or so.

Norah said: July 9, 20133:26 am

Also maybe something stupid that also really helps me: doing stuff with my eyes closed when I’m very afraid. Because I know the stuff I’m afraid of isn’t real anyway, I’ve found that a “If I can’t see it, there is nothing there” approach can work amazingly well. Strangely enough, it also works when what I’m afraid of is the dark.

This can be tricky because I have a lot of motor control, coordination, balance, etc issues that can make this stuff hard even with my eyes open, but I can manage with practice and always holding on to a wall with one hand (for balance and so I know approximately where my body and limbs are in space).
So when I have the rare flare-up now, I’ll go to the toilet with my eyes closed, shower with my eyes closed, brush teeth with my eyes closed (that one is extra tricky because of motor control and coordination issues), etc. And who cares that your teeth are maybe slightly less well-brushed than usual if it means you don’t have to sit in a corner feeling like your bladder is going to burst for the whole night until you pass out at 6:00 in the morning?

Anxiety is so much fun, such an easy thing to deal with, and something people who don’t have it take completely seriously. Especially when it’s a merry bedfellow with depression… even better then.

What was that? I dozed off for a moment, and you say it’s not really like that? No kidding. What I find most interesting about the moment, especially in relation to my own dealings with anxiety in particular, is that although people seem to be getting more open about talking about it, the functional responses of society/work/etc. to it aren’t catching up so quickly. I’ve recently started seeing a therapist to help with my anxiety problems, many of which are set off by work-related stress and social situations. This has been really helpful for me and my therapist, who does pluralistic (i.e. ,a mix of a lot of things) has been starting me off with mindfulness meditation and similar “homework”. This is really helping my manage the day to day.

I don’t have a formal diagnosis and haven’t sought one because I’m not sure I see the point. I’ve had trouble with GPs in the past, basically claiming that because I could pull myself together and express myself well at an appointment, that I wasn’t really (depressed, anxious, ill, etc.). I don’t know what a diagnosis for me would look like… I sometimes have had to stay off work, I get physical symptoms, but have never had e.g. a panic attack. So sometimes acknowledging the problem is real is pretty difficult because I have developed a lot of sophisticated ways of controlling the surface-level visible symptoms. If I acted how I felt a lot of the time I think it would really freak everyone out.

I also don’t particularly want to use medication because I feel that for me, in the past, it has been a way to avoid a more in-depth and long-lasting recovery that involves behaviour change on my part. It has helped, but I don’t think it’s the right help for me at this time. (That isn’t at all a judgement on people who do use medication, it’s a very important tool for many and lifesaving for many… just right now it isn’t for me. Chances are that if I find myself quagmired in another long depression, I’ll feel differently.)

I think that another thing that comes to mind immediately is that I am an outwardly confident person, I have strong beliefs and have made it work for me to speak out on behalf of those beliefs through feminist and other activism. I think this can be a really protective quality/set of behaviours but it can also be detrimental, for me, because people sometimes think I am “tough” and “strong” and “confident” (like those are fixed qualities a person has, rather than things that change depending on context). So for me, and for others, that seems to contradict sometimes the internal experience I’m having of totally shitting myself in some situations. In fact, what Lindsay said a few comments above sounds a lot like me at night and in social settings!

I look forward to seeing all the chat in this open thread. I’m not sure what I’ve said has been useful to anyone but me. I’m trying to be open about anxiety and depression because I think it’s healthy to incorporate those realities into my everyday behaviour and actively manage them, and also because it’s important for other people to either be able to say “I know those feels” or “I had no idea those feels existed, that was useful”.

Katie S said: July 10, 201311:32 pm

“If I acted how I felt a lot of the time I think it would really freak everyone out.”

This. Exactly. I think partly to make up for my anxious tendencies, and as a reaction to being female in a male-dominated field, I also present as “tough” and “strong” and “confident”… until I’m not, and then people totally freak out. I used to over-think and over-analyze before any interpersonal interaction, and when I ran out of the mental and emotional bandwidth to do that, I ended up acting how I felt, and boy did everyone freak out.

One thing I really hate about my anxiety is that I’m completely irrational with it! Like, the Gift of Fear is such a great book, and acknowledging that your feelings of trepidation around a person are a signal that something is Not Right, and schrodinger’s rapist and so on and so forth. Except my filters get so out of whack I don’t feel I can always trust my own instincts.

Like, one time early in my relationship with the mister, before he officially moved in with me, he left my place to go spend the night with some friends. And I started hearing a terrifying scraping sound that I thought was coming from the attic. It sounded like massive claws scraping along the floor, combined with something messy being dragged, and I was terrified. I spent a good 20 minutes frozen to the spot in the corner of my room wimpering before I got the courage to flee gibbering from the house and track him down, AT ONE IN THE MORNING AT HIS FRIEND’S HOUSE. When he came back with me (see? Keeper!) he worked out what it was. The neighbour was dragging a huge load of bin bags out into the alley. The alley directly below my bedroom window. I was convinced there was a literal winged monster in my attic to the point I fled the house, and the sound wasn’t even coming from the direction I thought it was!

And it all means I feel like I can’t trust my own sense of danger, or risk. I can’t always tell whether I’m being paranoid and irrational, or whether the man sitting at the back of the bus really is a predatory arsehole I’m right to be trying very hard not to make eye contact with.

…

Oh erm… one thing. I’ve never had a proper diagnosis as such – I’ve been in therapy, been on meds, been treated by my GP but none of them ever actually told me what I’ve got. And recently my other half made me aware that something I thought was normal is actually possibly not something everyone has, so now I’m wondering if it’s related to my broken brain. Does anyone else find they have a few annoying little voices in their head when they’re under stress? Like, the one that constantly counts stuff you’re doing – breaths, steps, seconds passing, or the one that narrates everything you’re doing, or the one that just swears all the time? I feel… really weird and nervous asking. I know the voices aren’t anything external, even during my worst irrational moments I know that, but when they start up I can’t actually exercise any control over them at all. They’re just THERE.

Lousie Dee said: July 9, 20135:35 am

If no-one involved in your treatment has told you what your diagnosis is, even if it’s only a provisional one, find other people to treat you. The only conceivable reason why I could see someone holding back is because they feel you wouldn’t benefit from it – and I call bollocks on that. Ultimately, YOU know best when it comes to your health.

If you haven’t already, bring up the voices with your GP and/or therapist. What will likely happen is that they’ll test your hearing and other things that could be related to make sure it’s not physical before looking at it from a mental perspective. I went through something similar myself (I get physically ill from sine-based sounds, plus certain frequencies and sound layering are enough to trigger anxiety attacks).

“Except my filters get so out of whack I don’t feel I can always trust my own instincts.”
“And it all means I feel like I can’t trust my own sense of danger, or risk. I can’t always tell whether I’m being paranoid and irrational, or whether the man sitting at the back of the bus really is a predatory arsehole I’m right to be trying very hard not to make eye contact with.”

^ I go through this myself. My psychologist calls it hypervigilance. She also tells me that my hypervigilance would have developed because it was necessary… It only becomes a problem when it’s no longer needed (in my case).

C S said: July 9, 20133:52 pm

That is really illuminating. I’m not sure if I have an anxiety disorder or not, but I get really paranoid at night and always sit facing the door in a restaurant (so do my mom and sister, oddly enough). Until I started training myself out of it, I wouldn’t even look at mirrors or windows at night. I once pissed off a friend’s roommate when I was staying in their apartment (I was the only one there, it turns out) and didn’t know not to lock their front door. She started banging on the front door, and even though a mutual friend kept calling my phone, I decided it (or maybe even he!) was an intruder and stayed away from the door until she left. She ended up sleeping on a neighbor’s couch. I felt like a huge idiot and asshole, though I was also pissed at my friend for not telling me to leave the door unlocked.

I haven’t had any real trauma besides being -really- sensitive to scary movies and stories, but my mom was sexually assaulted at gunpoint when she was in college and works with people who’ve been through horrible things, all of which I heard about when I was pretty young. When I brought up getting tested for ADD recently, my dad suggested that my symptoms might actually be anxiety. This makes me wonder.

Irene said: July 16, 20137:38 pm

Oliver Sacks’s book Hallucinations points out that auditory hallucinations are actually really, really common. (Well, lots of kinds are, but auditory ones are the kind of thing people get most wigged out about because it used to be dangerous to admit to a doctor that you “heard voices.”) I haven’t had the specific kind of experiences you have, but I have certainly heard things that weren’t there.

bokhyllen said: July 9, 20134:13 am

I have a lot of anxiety about doing things with other people, and also about people doing things around me- I know some of this stems from my dad being the most inconsistent person alive when I was growing up. It was rare for any plan (vacation, moving, etc.) not to go through several unexpected permutations just because he didn’t feel like doing x thing one day. Somehow, I usually ended up being the last to know. Couple this with not dealing with change very well and I now have intense anxiety over forming plans with other people.

Mostly I deal with this by making my plans through my brother- we have the same group of friends, so he arranges things and I don’t feel stupid about asking him for the details when I would probably feel that way asking anyone else the silly fiddly little questions and arranging for rides, etc. If I’m doing something that isn’t with him, I try to make my plans as specific as possible and just bite the bullet and ask the questions if I have to.

I also have free-floating nonspecific anxiety that gets especially bad when I’m waiting for things. I always try to have a book with me to distract myself (and, er, I get a little anxious about choosing just the RIGHT book to bring so that it won’t stress me out further, etc. and thus I end up reading Watership Down five times a year…) but I have ended up just bailing and heading home. I missed way too many classes in university that way.

Specific planning also helps to deal with my other anxieties (okay, I have tons and tons of them) like making phone calls (and then I break it down into tasks, like finding the number one day, calling them the next, so I plan my whole day around a phone call like it’s discovering the holy grail or something). A lot of time I need help to do that- when I’m really freaking out and crying because I need to do a thing and don’t know how to do the thing, my mom (super-organized) can usually help me figure out what I need to do and make it seem like less of a giant task.

Anyway I’m just gonna post this before I either ramble more or delete it all.

Silence said: July 10, 201311:54 pm

I also need a book with me at most times. Getting an ereader made it so much easier as I can have ALL THE BOOKS with me without extra weight. I might spend the first 10 min of my train trip deciding which to read but at least the deciding is happening while I’m moving.

bokhyllen said: July 11, 20132:30 pm

Yeah, I get rooted in front of my bookshelf and CAN’T leave until I’ve chosen a book. I’ve never actually been late for my buses that way, but it’s been close. Now I try to plan for enough time for that.

Lousie Dee said: July 9, 20135:03 am

A fantastic friend of mine sent me the link to this thread… I think she’s psychic, because this is *exactly* what I need right now. Thank you, Captain! I do want to reply to several comments, but I think I need to get this out of my system first.

My current diagnosis is Generalised Anxiety Disorder with PTSD and depression, but my psychologist will probably push the psychiatrist I need to start seeing (to get the medication under control) Complex PTSD with anxiety and depression.

I’ll likely need to be hospitalised in the next few weeks; the only reason why I haven’t checked myself in yet is because I’m meant to be visiting my family interstate family in a couple of days. While I know that these things do vary, I’d love to hear from those who have done a stint in hospital for mental illness… How did you find it?

What’s stopping me from doing a stint is my mother will freak out if I skip this trip because I’m in hospital because I’ve gone over the edge, plus a MASSIVE fear of being sexually assaulted… I can’t afford to get a private room, and I shut down in those situations (part of my PTSD stems from being sexually assault).

I know that my thinking is severely unrealistic – I just can’t seem to shake that fear.

Oh, I didn’t know that there was already something written up – my apologies

(Also, reading now~~~)

JenniferP said: July 9, 20136:02 am

No apology necessary! It’s from a while back, you wouldn’t have stumbled across it. And people in this thread might have more specific advice.

Edoro said: July 9, 201312:05 pm

I spent a week in a mental hospital last November and it probably was the best decision I’ve made. Long story short, I was in a terrible depressive spiral – dropped out of college, had no job, my car broke down, no friends closer than thirty minutes away, stressful and unsupportive family, etc.

My best friend drove me there and waited with me to be admitted. That took a really long time, several hours at least. We got there around five or six and I don’t think I got admitted until nine or ten. At first I sat in a waiting room like you’d see at a doctor’s, waiting to be called. Eventually they called me back to go talk to a guy about how I was feeling, which I sort of think of as me making my case to be admitted. He asked pretty typical questions, like: what’s going on, how do you feel, do you think you’re a danger to yourself or others, things like that.

The actual hospital experience was equal parts relaxing and boring. The day was very structured – we’d wake up around seven-thirty for breakfast, have a smoke break after breakfast, go to the first group, go to lunch, go to the second group, go to dinner, go to bed, get woken up… If you chose not to go to the groups then you had a lot of free time, but there wasn’t a lot to do. They had two little break rooms with TVs and magazines and crayons and you could do some more fun things in art therapy, but mostly people just watched the TV or talked or wandered around or stared at things. Definitely bring some books when you go or you’ll probably be bored out of your skull.

It was also very relaxing. I had a whole week where I could just not care about anything, at all. I didn’t have to worry about being Crazy or Weird because everyone was there for being Crazy And Weird and they weren’t going to look unkindly on me for having issues in a mental hospital.

The people there were all very friendly. There was a real sense of camaraderie. We were all in this together and we were all making a journey towards getting out together. Some people didn’t seem very sociable but no one was mean or scary.

As for being sexually assaulted – I can’t promise that that won’t happen, because there’s no perfect guarantee. I can tell you this: first of all, you definitely won’t be in a co-ed room, and second of all, people will almost certainly be watching every hour of the day. There will be nightshift people during the night. The way my hospital was set up, there was a nurse’s station at the end of the hallway the rooms were in, and there was no way you could go anywhere without someone there seeing you. If I needed help, there were definitely within earshot of a scream, and they’d see anyone who tried to sneak into my room. Obviously not every hospital is built the same way, but making sure people can’t sneak around should be a pretty big priority at any mental hospital.

I would also recommend talking to them about your experiences and fears if you can. They may be willing to accomodate you, since the whole goal of hospitalization is to help you be able to function well enough to get out reasonably soon. It definitely can’t hurt to ask. The people working there deal with issues like this all the time.

Ruby B said: July 9, 20136:06 am

Like many people here, I don’t have an official diagnosis, mainly because anxiety doesn’t distress my life to a point where I can’t deal with it. It helps very much that I don’t get panic attacks. I do go into anxious spirals of doom that are very frustrating and tough to pull out of, and when life gets overall stressful, I get paranoid. I know that being 29 and scared of home intruders is, in this case, the same as being 6 and scared of dinosaur bedroom intruders, but it’s still hard to negotiate with myself. Two things help me, and perhaps they can help someone else: sports and being brave.

My exercise of choice is running outside. In every place I’ve ever been to, people complain about how hard it is to run outside there, unsurprisingly: here it rains a lot, there it’s idiotically hot, over there is hot and humid, and over here gets idiotically cold over the winter. But that’s what running outside is all about for me. Because when I’m soaked through with rain and sweat, with dead bugs down my throat and mud splashes up to my knee and heavy metal blasting in my ears, I feel like a million bucks, like King Kong on cocaine. I possibly look my worst, all sweaty and red-faced and out of breath, but I feel my best and most beautiful, because a running woman doesn’t have to worry about her looks – she’s already beautiful by being active. I’m afraid of being even a little bit like my mother (doesn’t help that my face is so much like hers), but when I come home splashed with mud, I look at my shoes and think, This is how Dad’s shoes looked when he played soccer on Saturdays, and the thought of being like my dad makes me feel bigger, stronger, so sane and solid like him. When I’m anxious or scared, I can go running, and it will take the edge of, and if I keep running hard for a few days in a row, the paranoia goes away and I feel free. Running makes me a champion, it makes me feel powerful, and there is nothing like feeling powerful for anxiety. Not saying that running is the thing for everyone, but perhaps you can find the exercise that is “yours”.

And when it comes to specific tasks and I’m terrified, it helps if I tell myself to be brave and face it. Yeah, I know, probably not helpful to a lot of you, but it helps me tremendously. These things come up, and the what-ifs are endless. I’m scared of flying home for a break because I have to take a tiny island-hopper plane, and last time I seriously though we were going to crash and I would die. I might be scared of picking up the phone and calling a local business because the accent is very tough, and I can’t read lips over the phone. Sometimes I tell myself that I’ve survived tougher, and my brain goes, Errr, actually… But it helps if I tell myself to be brave and do the thing I’m scared of. I’ll admit to myself that I’m scared. Then I’ll go and do it anyway. Like a lot of people here, I survived some tough times and got myself out of very difficult situations, and I wear those like mental medals, those times I fixed very bad situations with guts, stamina and preparedness. So when I’m scared of something, big or small, I look at my mental display of medals, and it makes me feel like a tough chick. In the end, I can get myself out of anything. and the one thing I can’t beat will be the thing that kills me, and then it won’t matter because I’ll be dead.

misspiggy said: July 9, 20136:18 am

This is a lovely thread. I don’t know if it’s helpful or relevant, but in my case it turns out that Things about my body and nervous system mean I’m likely to have high anxiety, panic attacks and so on (and indeed I do). For some reason I’ve found this knowledge very helpful. I guess it’s because I no longer feel that I need to fix myself, other than managing my behaviour so that I can live my life.

I feel under no obligation to be Not Anxious, because I am going to be anxious for much of my life and there’s not a darned thing anyone can do about it. Before that, my perfectionist Jerkbrain had ‘oh, and don’t be so freaked out all the time’ high on its list.

Er… I’m not being very clear. But it is possibly useful to reflect that everyone is made differently, and major anxiety is part of the makeup of several of us. We don’t need to apologise to anyone, including ourselves, for being the way we are.

Lousie Dee said: July 9, 20136:55 am

THIS.

I still remain positive (on neutral/good days, at least) that I’m going to be able to function properly in the future – this comment’s just reminded me that I don’t have to be completely better, just managed.

It’s good enough for me.

Anonie said: July 9, 20139:28 pm

I have some things related to high anxiety too. It kind of takes the pressure to be “normal” (what even is that?) off and makes the anxiety seem like any other random trait that we have.

bardulph said: July 9, 20137:30 am

I don’t have the really debilitating problems that some posters here have, but there are many ordinary things that I find very difficult to do. It was a great relief to read about Tired Caregiver’s apprehensions about getting into new situations and perhaps not knowing what to do. I thought I was the only person like that! Even really everyday things like going to a new barber or phoning someone I don’t know can be incredibly stressful for me; it takes a long time for me to work up the courage to do it – but when it happens it’s invariably fine. I hate feeling as if I don’t know the rules.

The thing that makes me most anxious is my tax return. I have failed to file it now for the last TEN YEARS and have incurred fines in excess of THREE THOUSAND POUNDS because I simply will not do it. I don’t know what is stopping me – but the idea of sitting down to do it is simply not on the radar. It’s the idea of someone looking at what I’ve done and somehow judging me on it – I can’t bear it, and I will do almost anything to avoid doing it. I’ve made the job smaller in the way another poster suggested which was great – I’m now much closer to submitting it that I have been in years – but oh my it is so so hard.

And the stupid thing is that I’m by and large an intelligent and successful person. But this one thing is dragging me down the whole time – hangs over me like a black cloud – stops me from making any real plans for the future – because every time I think about long term things I remember I haven’t done my tax return so I won’t know how much money I will have. Doesn’t it sound stupid?

My sensible brain has long ago worked out how to override my anxious brain in most circumstances, so my strategy for dealing with things which make me anxious is to just bloody well go and do them. It’s not a strategy that would work well for everyone; I think it’s because I’ve had a lucky history of mostly succeeding at things (except my love life – hah!) I can convince myself to do stuff which I find intimidating. Indeed sometimes I have done things simply *because* they are intimidating. But this hasn’t diminished my anxiety over my tax return. I think once I have done it once I will be OK, but it’s such a long, hard, horrible journey, and I don’t feel as if I can talk to anyone about it – it makes me so ashamed, it’s such a small thing, but I just can’t make myself do it. I’m a Chartered Accountant, for god’s sake! That’s what makes me particularly anxious about it – as if I ought to find it super easy to do because I’m financially qualified. But that makes no difference to my feelings about it. I don’t know if I have diagnosable anxiety, but reading this thread makes me think that perhaps what I am feeling is on that continuum.

Even just talking about it here is a huge relief. Thank you Captain for providing this wonderful space. I read everything here and I think it’s amazing what you and the Awkwardeers do🙂

I hadn’t done my taxes for 7 years, and I have the simplest possible life possible. The things that worked for me actually getting it done in my lifetime: strong meds, and a partner who is good with financial stuff. I asked them to help me out with things, with calling and collating and filing, and with buckets of crying and meds I managed to get them all done.

So, you’re totally not alone in totally avoiding taxes for years and years and everything is doom sorta feeling.

bardulph said: July 9, 201310:05 am

Thank you. This might even get me a bit closer to actually doing it… no partner here, but I did think about asking an understanding friend to help. Time to mull about it some more!

XtinaS said: July 9, 201312:32 pm

For me, it started when I moved to a different state. I didn’t know how to file, and so I just… ignored it.

For 7 years.

One thing I would possibly recommend: accept that it will take a while to do, because anxiety. It took me the better part of a year to file 7 old 1040-EZ documents, because I couldn’t always deal with it, and that was okay. It kind of had to be okay. My partner kept telling me that it wasn’t doom, that the IRS deals with worse every day, that it’ll get done and then it’ll *be* done.

Also recommended: possibly hiring a bookkeeper or accountant for doing this. Tell them up-front you have anxiety and can’t do a lot of things, and hope that they’re not dicks about it. (That’s what I would’ve done, were it not for R.)

I was in the exact same boat – didn’t do my taxes for 7 years and the anxiety spiral that would happen when I even thought about it was awful. About a month or so ago my brain gave me a small window where it wasn’t nattering at me about what an awful/stupid person I was for not filing, so I found an accountant, emailed them, explained a bit about why I hadn’t filed, and their response was thoughtful and kind. So I made an appointment. Now? After shelling out a few hundred dollars, my taxes are done, and I have a payment plan to get the resulting fees paid off. It took me about a year or so of telling myself I was going to take care of it, but that portion of my brain weasels is now silent, thankfully. It was scary, for sure, but I feel so so so much better now.

secretrebel said: July 9, 201312:51 pm

Hi, I had the tax return anxiety. It got a bit better when I had some more money because I realised a lot of my personal anxiety was to do with the fear that I would always be in debt and there was no point trying to fix it.

But what helped the most was hiring an accountant. Instead of incurring massive late fees and making myself sick with nerves and angry at myself I pay someone else who just does it. I realise this is a solution that only works if you can afford it.

But the fact that you have the skills doesn’t mean you have to do the job. You can outsource it who has not just the skills but the desire to do it.

Nothing stupid about it. I haven’t missed any years, but for a while it was only because of turbotax being easy. Now mr wit does it and I am so glad. I am all for hiring someone to do it for you! Even if it is normally your job! Because, if you have the money, you can exchange money for goods and services….. And for reducing anxiety. So worth it.

Ellen said: July 9, 20138:39 am

I have panic disorder, and I characterise myself as a worrier – even when I’m not experiencing clinical symptoms, I worry about things.

My panic is under more control now than it was before. What happened to me was that I developed acute anxiety after my dad’s sudden death, and for various reasons became utterly convinced that I was going to die in the same way, similarly suddenly (aside: my dad was 44 years older than me and had a completely different lifestyle). So I became a total hypochondriac, convinced that every physical sensation was an insidious Thing about to kill me. Especially sensations like heart palpitations, dizziness, hyperventilation, breaking out into a sweat and ALL THE OTHER panic attack symptoms. So each time I had an attack, I decided the symptoms of panic were in fact symptoms of something more serious.

A few things helped:
– A book called When Panic Attacks, by Dr Aine Tubridy (she was Irish so her book may not be widely available elsewhere but Amazon may have it). She takes a very medical approach to panic, outlining what each of the symptoms is, how it feel, what triggers it and why it’s not inherently dangerous. In the second half of the book, she goes into chakra-based healing techniques which are not my thing, but I found the first half super-helpful. She also has little boxes with bold print saying things like: If you feel sensation X followed by sensation Y, this is PANIC, not Disease A. Seeing it in black and white, written by a medical doctor, helped a lot.

– Xanax. I take it very rarely now – at my peak I probably took it 3 times a week – but I always have some within reach and knowing it’s there helps.

– I went on a train trip around Western Europe. Yes, this is not a classic solution, but I really wanted to go, and my travel buddy was a very close and trusted friend, and I briefed her fully on what my panic attacks look like and how to handle them (Step One: Tell me to take appropriate medication. Step Two: Repeat Step One). I also made sure I had travel insurance, contact details for ‘safe people’ (my therapist, my GP, my flatmate etc) in a few places in case I lost my phone, and enough Xanax that I could take them as needed. When I got back (and while I was there) I was so shocked that I’d managed to go backpacking with panic disorder that everything else seemed a bit less scary.

– After a couple of years of treating the panic, I decided to get myself checked out for any susceptibility to what killed my dad, so I could take steps to prevent it if needs be (my GP pointed out that testing wasn’t medically necessary – it was just undertaken to help treat my panic). Turns out I’m no more susceptible than the next person, which was great news, but if I had been, I was prepared to deal with that.

I’m now at the stage where I am frequently worried but rarely unmanageably so, and when the panic gets really bad, I tell myself ‘You backpacked around Europe with this. Seriously. You can totally get on the bus and go meet people.’ And then eve if it feels unpleasant, I know I can do it.

Of course, now that I’m not worried about getting what my dad got, I’m worried about getting Other Things. Sigh. It continues. . . I have accepted that I’ll never be a carefree person and I’m fine with that (my Jerkbrain isn’t, but I am *grin*). For me, the goal is to find tools to cope, not to try to eliminate an aspect of my personality – that way disappointment lies, I think.

I’m also working on some depression issues at the moment, and I’ve found the resources on Captain Awkward great🙂

Pterinochilus murinus said: July 9, 20139:22 am

Some people mentioned CBT. I’d like to put in a word for people who find CBT really unhelpful and scary and awful. If it works for you, great. It works for lots of people, and that’s good. If it doesn’t work for you, you’re not alone, there are other forms of therapy, and the stuff about how it’s the only evidence-based therapy out there is no longer true.

Also, CBT itself has evolved and the newer-school versions of it are less, um, less of a blunt instrument. But if you’re doing it from a workbook or a website, you’re probably still getting the older-generation stuff, and it’s also not specialised to you and your problems. So… if it works for you, that’s great, but if it doesn’t and you’re blaming yourself, it’s not your fault and you’re not alone.

Just in case I’m not the only person out there who’s struggled with a therapy modality founded on “You’re anxious because your thoughts are wrong and you need to stop thinking those thoughts.” Or who wanted to kick NoProblemos’ ass (MoodGym character who does not have anxiety and is there just to show you how a normal person thinks and feels. Of course he is male, he’s a normal person.)

Phospher said: July 9, 20133:47 pm

Thank you for this. I did have a therapist, and I think maybe CBT might have worked better for me if the therapist had been better and less “Oh, those few things you’ve found that help? Fuck those things, they’re silly. Building your own closure wrt a distressing relationship? No no, you should probably torpedo such peace of mind as you’ve painstakingly built — oh, maybe that WOULD make things worse, I dunno, but you should sure agonise over which you should do! Have I completely wrecked your composure yet? Good! We will teach you strategies on how to deal with that next time.”

The reducing me to tears bit was always now, the strategies to deal with it were always “next time.”

Anyway, because it was supposed to be the one true thing, even while part of my brain thought “This is making me feel terrible and I have never believed that regularly making someone feel terrible is a sensible path to mental health, therefore I am stopping now and lo I feel better,” … I still had a lot of shame about how plainly I quit when it got tough, I don’t have the guts or staying power to do therapy properly. So now too much talk of how great CBT makes is makes me, guess what, anxious, even though I completely believe it is helpful for many people. MCBT from a book, by contrast, worked wonders for me. The “M” part makes a world of difference to me!

I am never going to find making a mood diary helpful, in any discipline, though.

CBT seems to work best for people who think themselves into anxiety spirals. I think myself out of them, most of the time. Judging from stories — here and other places — I’m not unique, just in the minority. This is not the dominant therapeutic narrative around anxiety, and it takes for-bloody-ever to explain to people that I cannot stop the anxiety by changing the way I think, because it’s not based on thinking. I panic at the speed of instinct, and by the time I’m aware of thinking anything it doesn’t matter, because the alarms have already started going off. The only thing that has ever made a significant difference was when someone finally believed me when I said, “Look, something is evidently wrong with the not-conscious-thinky part of my brain, Please give me some damn drugs to flip the broken switch when it get jammed.”

Having this model of anxiety problems, CBT never did anything but make me worse. It was someone else demanding I do a thing I didn’t have the ability to do and then when I didn’t do it, telling me that it was my fault for not trying harder.

Phospher said: July 12, 20131:14 pm

Yeah, that explains it quite well. I think I confused both my therapists because I didn’t have much in the way of negative beliefs I could be persuaded out of, not on a conscious level anyway. The first one kept saying, “Well, you seem to already understand everything, I don’t know why you’re here..?” and I would be all “Because intellectually understanding things isn’t making me feel better! I am really good at thinking and terrible at feeling! Surely that is not that strange!”

A big part of my problem was that I hated having emotions that do not make logical sense. I hated it so much that I would be honestly incapable of recognising I was having them, and would push them out of my consciousness until they were causing me significant physical distress, and I really needed a way to alleviate the immediate pain before I could begin working on some of the unhelpful attitudes that were lurking there deep down. I guess that’s how the therapist kept reducing me to tears, actually, he would make me focus on my worst moment of the past fortnight, presumably with the intention of isolating some sort of conscious belief he could demonstrate was factually incorrect and the spell would be broken and somehow I would feel better. But there really WAS no such thought, and I desperately needed ways to NOT focus on my worst moments, but rather just to accept that they existed and learn to let them pass.

Nymerias said: July 9, 201310:20 am

I was diagnosed by a primary care physician with an anxiety disorder a few years ago, when I was at my worst period of Not Getting Things Done Because They’re Scary. I tried medication for a short time, which I did not like or find helpful, and I saw a counselor briefly, which I liked and found helpful, but I’ve never seen or been diagnosed by a psychiatrist. So sometimes I feel uncomfortable talking about my disorder in concrete terms. It doesn’t help that I am, by all appearances, a pretty successful person with a happy life, who does things like date and travel alone without much fuss. Sometimes I feel like I don’t have a claim to anxiety, even though I know it is real and causes me significant distress. But I come from a family that is very “bootstraps” oriented and has instilled in me that I should be able to conquer it myself by simply doing the things that scare me until they don’t scare me anymore.

That works, sometimes. But I would also like to not be physically sick when something that scares me comes up, and now that I’m seeing someone new that I am really invested in, I’ve been having a lot more frequent anxiety worrying that he is going to leave me or lose interest. I get pretty bad physical symptoms from it too, like upset stomach, dry mouth, and rapid heartbeat. It sucks, because even when I’ve managed to calm my racing thoughts, often a physical symptom will resurface and drag me right back under. Unless I’m specifically triggered (by canceled plans or a missed text, usually), I often can’t even mentally tell that I’m anxious until I’ve been feeling physically shitty for awhile. I hate it and I hate that it’s making me feel insecure in a really nice new relationship that needs air and sunlight to grow.

I have not acted on my anxious feelings around him yet. He knows I get anxiety sometimes (and witnessed it once and was very cool, but it was completely unrelated to him). I don’t get anxious at all when we’re together and I’ve conditioned myself not to act on my irrational need for attention. I usually try to distract myself, take extra care of myself, or talk to my mom or best friend if it gets really bad. I think I’m making a lot of progress in making peace with whatever the outcome of our relationship is, but I’d still like to know what it’s like to be chill and not constantly wonder if we’re going to stay together. I’m trying to be patient and let things develop naturally, but it’s hard to tell when my instincts are trying to tell me something and when I’m being irrational.

I think that’s the worst part of anxiety. I take pride in my ability to make good choices, and I often feel like I’m entitled to a good outcome because I do consider things very carefully and treat others well whenever I make a decision. And I like to think a lot of that comes from having well-honed instincts. But I need to accept that a) I am not entitled to constant happiness or to get what I want in all situations and b) that sometimes I cannot trust myself because my anxiety overrides my instincts. Sigh. I’m trying to set up an appointment with a free counseling center, so hopefully that will help me find some new coping strategies.

I, too, have generalized anxiety. I quit my job a few months ago for personal reasons and although I’ve acquired part-time work, I’ve become increasingly depressed which has (of course) ratcheted up my anxiety to approximately 2 billion. I’ve found it increasingly difficult to leave the house as of late, and am doing that thing where I cry and can’t figure out what’s going on, and have a panic attack, and realize that nothing on my to-do list will ever get done and I should probably just sit in my closet, close the door, and wait to perish.

Now, realistically, I know what I should be doing about this—I should take meds that I was prescribed and I should work through my CBT exercises. (My therapist—who I am not currently seeing—has this great elevator image thing. You imagine yourself as super anxious (10) and take a minute to be “on that floor” and then imagine the elevator going down floor by floor. You take breathes and give the anxiety a minute—but just a minute!—and then, hopefully, let it go and take the elevator down another floor.)

My biggest problem right now (which is always my biggest problem when I get overwhelmed) is self-sabotage. My anxiety keeps me from dealing with my anxiety and it is just this whole snake-eating-its-own-tail situation.

What do you guys do to deal with self-sabotage situations?

WKP said: July 9, 201312:29 pm

That sounds like it really sucks. My anxiety sabotaged any possibility of treatment for a long time – albeit in a different way to what you described. I have severe emetophobia (phobia of being sick), and the thought that treatment would involve thinking about/talking about/looking at/etc The Worst Thing In The World (and thing that feels so bad as to be worse than death, for real) made me way too scare to actually go for treatment. For years and years I told my parents that the reason I didn’t want CBT was because I knew it wouldn’t work for me, because ‘CBT is for people who have never learned to introspect’. When in reality, I didn’t want CBT because my anxiety was making me too anxious to do anything about the anxiety.

In the last few months I hit a break point, pretty much the lowest point I’ve been in. I was having panic attacks almost constantly every day, pretty much unable to eat, completely unable to leave the house. I was sort of passively suicidal, in a way that’s only possible when death in itself is one of the main sources of my anxiety. I wanted to die because I didn’t want to go on living as I was, but I was too scared to ever actually do anything about that urge.

Really I needed my close family to draw attention to how bad things were. They just kept saying “Nothing can be as bad as you feel now. Being sick is not as bad as this. Getting CBT is not as bad as this. Taking medication is not as bad as this.” I needed to realise that I simply could not get any lower – things could not get any worse. At that point I used the apathy created by my depression (ie “I don’t care what I’m doing as long I don’t need to think hard enough to make any of the decisions”) to allow me to finally get some treatment. My parents helped me contact doctors and mental health services and I’m now on antidepressants and will be having my first CBT appointment tomorrow.

I guess my advice to you would be to try and use those same thought processes. Like you said, you feel like you may as well sit in the closet and wait to die. If you care *that* little about your life and your future, then what the hell reason do you have NOT to get treatment? It won’t make any difference anyway, right? You’re going to feel like crap forever until you die (I’m just speaking along with your jerkbrain here, the truth part comes later). So you might as well go through the motions of treatment, even just because it’s the ‘thing’ people keep telling you to do. Once you’ve done that and shown everyone that you’re never going to feel better, then you can go die in peace and everyone will stop bugging you about it.

/jerkbrain. Some of that was obviously true – when you feel this terrible, you are mostly immune to external circumstances, because you feel so bad all the time that it’s hard for it to get selectively worse. But the false part is that treatment is JUST a ‘going through the motions’. The truth is that once you’ve made the first moves and got yourself involved with the right people, they won’t give up on you until you’re feeling better enough that you can talk over jerkbrain and help yourself make progress.

J. Preposterice said: July 9, 201311:34 am

Oh. Something else I found out.

When I was pregnant with my first child, I disclosed my diagnosis to my midwives. They Fucked. Up. Really, really hard. I ended up having them redact my medical records because of some TOTAL BULL they put in there that was them hearing the anxiety equivalent of “anaphylactic shock” when what I actually said was the anxiety equivalent of “unpleasant allergy season right now”. It was a fucking mess and for real, I wish I’d never disclosed to those jagoffs.

I was with a different midwifery practice for my second kid, and seriously considered not disclosing. Eventually, I decided to tell them: look, I have a diagnosis of Generalized Anxiety Disorder. It is well-managed and I am under care for it. With my first pregnancy, my pregnancy care providers did X and it was a major problem, and one of the big reasons I’m here with you and not with them anymore. I need to know how you handle patients with these kinds of diagnoses, so I know if I need to change practices sooner rather than later.

The midwife looked startled, and then said “…it’s not an issue? We do general checkups on your mental health but unless your scores on assessments indicate you’re having unusual problems it’s not something we look at.”

So, if you have anxiety — or any mental illness — you might want to feel out various places on how they handle this kind of thing before getting care from them (pregnancy care or otherwise). Because some places will screw up royally because they can’t hear anything over their fear of your illness.

Katie S said: July 10, 20132:46 pm

Thank you for this! Before my husband and I even started trying, I searched for an OB who would a) let me ride a bike and eat sushi through my pregnancy and b) not make a big deal about the medication I take for my anxiety. There were tears in many a doctor’s office before I found someone who was supportive of letting me continue the things I need to do to function while being pregnant. (Okay, so sushi isn’t one of them, but it was a good litmus test for an overreacting doctor who isn’t up on his or her research.)

Unfortunately the big, unexpected source of negativity on this was my actual psychiatrist. I was at first extremely reluctant to go on any SSRI because I knew we wanted to start a family soon. It wasn’t until I was almost fired for acting out at work (when I’m triggered my anxiety can manifest as verbal aggression, which was hard for me to see because I felt scared, like a cornered animal, and got no feedback until the almost-firing-time) that I agreed to go on, and only if he thought I could go off in a few months so we could try for a baby. At that time he assured me that my dose was low, the risks were low, and I should go for it. Once I told him I was pregnant he totally changed his tune, not ever saying he was against me continuing to take it but repeating all the remote but horrible things that could happen if I did (even things I had specifically asked about before starting the medications, and he had dismissed my concerns at that time) in the interest of me “understanding the risks.”

This is making it hard for my jerkbrain not to kick me every time I take the pill I now know I need to function as a reasonably happy human being, supportive partner, successful mother, and to hold down a job.

I’ve gotten panic attacks for many years (about death… only death. no social anxiety or anything) , but when it started to get much worse in 2009, I decided to go on medication and see a therapist. I was put on Celexa and I’m still on it but a couple years ago I cut my dosage in half and I plan to go off it entirely, eventually. One thing that helped for me was going to a therapist that specialized in OCD. OCD and panic/anxiety are often related, and using OCD techniques was really effective in minimizing how often I had panic attacks. I went to him for about a year and now no longer feel the need for therapy. But if I do start to feel more anxious again, he made me personalized CDs to listen to, (of him re-explaining the things he taught me in sessions) to remind me of what I had learned. Really very helpful.

Anonie said: July 9, 20139:37 pm

OCD is an anxiety disorder. What do you mean by OCD techniques?

Mary said: July 9, 201312:51 pm

This is probably going to get buried and no one will read it. But whatever. Gonna vent.
So, I’ve been living with Generalized Anxiety Disorder and depression since I was, oh, 11 years old. I’ve been to three different therapists, but not since two summers ago have I seen a therapist. I’ve learned how to cope with it, though it still gives me a lot of shit. The thing I absolutely hate most about this is you can tell yourself or tell others that it doesn’t control you, that you’ve learned to live with it. This is false. Anxiety will always control what you do. It will always affect you and the way you live your life.
I’m so sick of that.
I’m also sick of keeping it a secret. I don’t talk about it with anyone ever except for my boyfriend, and I can count on my two hands the number of people who I’ve told about these problems even once. I don’t tell people because it’s just not worth the bullshit most people spew about this, no matter what their intentions are (“I feel the same way – I get sad sometimes”; “Why don’t you just be happy?”; “She’s crazy”; etc.) but at the same time I feel the only way we can truly end the sigma about mental illnesses such as these is to talk about them openly and frankly and help people understand. I kind of want to do some kind of activism about this, but I don’t know how or what yet. I’m taking baby steps now but would be very happy to see that come to life somehow.

I think there is a difference between anxiety affecting us and controlling us. The distinction is very important to me, because it is the difference between well-managed but chronic mental illness and acute flare up. I mean, I shouldn’t have to learn all these skills just to go about my life, but they are some pretty awesome skills about introspection and self awareness and emotional regulation. We who have found ways of living with this shit are badass emotional ninjas.

JenniferP said: July 10, 20138:43 am

“We who have found ways of living with this shit are badass emotional ninjas.” – YES. That is the impression I am getting from this thread.

Mary said: July 16, 20139:43 am

Sorry I just got to see the replies today – thank you for your thoughts! I appreciate that you read what I said. “We who have found ways of living with this shit are badass emotional ninjas.” I love this and agree.🙂
Also, I do agree with well-managed illness vs. flare-up. I suppose for me, what I meant by “controlling” is that in order to manage my mental illness, there are things that I can’t do that I would like to do (ie, I would love to pack my schedule with all kinds of things every day and every month, but in order to best manage my anxiety, I can’t do that. That’s what I meant by it ‘controls’ me).
You keep being a badass ninja!

Phospher said: July 10, 20131:13 pm

I read it too.

I don’t want to tell you it’ll definitely be fine and your anxiety won’t always control you and make you feel so bad. I do THINK things will improve for you, but I don’t know, this is a disease and no one can predict its course for another person. I’m wary of even saying “it’s POSSIBLE”, because a malevolent brain can turn that into “It’s possible, so you suck for not being able to make it happen.” But I can say you don’t deserve this, and that neither I nor you know it WILL always be this bad. It may be that it never completely leaves you, but one day it’s like your old war wound that aches in cold weather, but is no longer constant agony and doesn’t restrict your movements any more (though you have to remember not to overdo it/take more hot baths in the winter). If you can’t get to that state, it’s not your fault and it’s not because you’re weak, but that state does EXIST.

If you want to talk about it/pursue activism, do, but any time if you don’t feel safe to do so or talking about it is exhausting, please don’t beat yourself up about it! You’re allowed to recuperate behind the lines before you hurl yourself into the fray.

Mary said: July 16, 20139:56 am

Hi, I’m sorry I haven’t gotten to see this response until now, but thank you for reading and responding🙂 Those are definitely wise words – “If you can’t get to that state, it’s not your fault and it’s not because you’re weak, but that state does EXIST.” This is something I forget sometimes, that it really isn’t my fault. Thank you very much.
I read your post below too. I’m glad you’ve found things that work for you and help you – you don’t deserve any of the Crappy Feelings that Anxiety and Depression Cause either. Keep being a badass and let’s show this disease who’s really the boss.

Phospher said: July 17, 20131:04 pm

Thank you, it’s very nice to hear back from you and that was a lovely response. I hope things will be much better for you very soon.

Phospher said: July 9, 201312:51 pm

Finally, it hit me that I could no longer remember what it was like to have a normal heartbeat. It hit me only because I’d just arrived late to a friend’s wedding (completely unavoidably not-my-fault late, I cannot control FLOODS) and was chatting to a friend I hadn’t seen in a couple of years, and she, naturally, said “how are you?” and, with a smile on my face, I told her. And she said “…Oh. Maybe you should try beta blockers?” And for the first time I HEARD what I’d just said, which was that I was a bit flustered, in fact I had palpitations, but well, I had palpitations literally ALL THE TIME, haha. I had presented this as a vaguely amusing fact of life, but perhaps it had something to do with how desperate I felt, how close to tears a lot of the time, and perhaps it was actually a medical problem.

“So you’ve basically been anxious since you were eight,” said the GP.
“Well, who hasn’t?” I said.

When I’m ill (I’m pretty much okay at present!) it’s often intensely physical. Sometimes I even… *worry* that my anxiety isn’t really anxiety because I’m not always worrying about, say, my family dying or whatever. My brain will often tell me that everything’s fine while my body insists we’re going to DIE at any moment. At worst, the palpitations can be so intense that even walking across a room is difficult, my throat tightens, I feel sick — it can get so eating is almost impossible which exacerbates the weakness and dizziness caused by the palpitations. Eventually, of course, this makes it impossible for my brain to continue to insist that everything’s fine, but at this point it’s hard to think much at all beyond “I can’t do this, I can’t do this.”

Insofar as the worries even have content, it’s something like this.

1) Something is going terribly wrong (probably something to do with my career or finances)
2) I don’t know what it is, so I can’t stop it.
3) Even if I DID know, I wouldn’t be able to deal with it, because I’m weak and useless.
3a) I might have been able to deal with it once upon a time, but I’ve frivolled away all my talents and intellect and now it’s too late to make anything of my potential.

So I tear myself in two trying to work out what the thing is and trying NOT to work out what it is at the same time.

Sometimes this fear can latch onto something specific — the bank called! They must be going to tell me I have no money and am probably somehow guilty of a crime and owe everyone in the world ten million pounds now. But often that I don’t *know* what I’m so scared of just circles back into the fear like a perpetual motion machine.

Eventually, this turns to depression. The anxiety burns up your energy and will and sense of humour and ability to imagine anything different, and eventually there doesn’t seem to be much left. Last time I could feel myself on that slide, I even wished the depression would hurry up and HAPPEN already because it felt as if depression would at least be a little calmer and quieter. (I’m not saying this is an accurate view of depression!) I usually tell people I have/had “depression” rather than anxiety, because it’s true and although there’s a long way to go even with depression, it seems a little easier for people to understand. And a big part of me feels like anxiety is a really pathetic thing to have in a way that depression somehow isn’t — “I sometimes feel life is meaningless” seems a little more dignified than “I am sometimes terrified of the phone.”

What helps:

* Anti-depressants. But I’ve now been off them for over a year!

* Going caffeine free for a bit.

*Letting myself feel the feelings. Even before I learned about mindfulness I worked out that trying to fight off the sensations by telling myself everything’s okay. Stop fighting them off, say to them, “fine, come in and do what you want.” The barrage stops instantaneously, it’s miraculous.

* Exercise. Even if just walking to the end of the street. I know there’s some disagreement about whether this is any good for depression on its own, but I do think it helps for anxiety. At least, it helps me — if my body is going to be flooded with adrenaline ANYWAY you might as well do something with it, and the. This can be VERY HARD, particularly in the “cannot really walk across a room/eat” stage. Repeating to myself “you do have a choice, you do have a choice, you do have a choice” — for an hour if necessary to get myself off the floor and out of the house.

* Treating the nausea as if it were any other kind of stomach upset — rice, crackers, etc. This both means my physical resources don’t get quite so depleted, and helps me stop thinking of . Also I discovered I can almost always eat sushi which is useful when I’m not completely flattened yet but getting close to it.

* Mindfulness. MINDFULNESS MINDFULNESS MINDFULNESS. Thank God for Kabat-Zinn. I’ve tried therapy twice, once was fairly harmless but also pointless (the therapist liked to witter on at length on her theories of life, then pepper me with mild insults), the other time was just a reliable way to end up spending three hours sobbing and two days recuperating. “The Mindful Way Through Depression” is the best substitue I’ve found. While I do kind of wish I could have found a good therapist, I also figure I learn best from books in other areas of my life, why not this one?

*Saying yes to almost anything social anyone proposes, but on the other, trying to be kind to my need for rest and quiet. It’s obviously difficult balance, (and I did overdo the “yes” side a bit recently) but worth trying to strike — and to carrry into the rest of your life when you’re not actually ill any more. For instance, I’m trying internet dating at present. I decided I would only meet anyone for an hour in the first instance. Far less to stress about — even if it’s awful and awkward, peace and relief is guaranteed REALLY SOON! — so I’m less likely to burn out and stop doing it.

*Trying not to make myself anxious as a kind of payment to the universe to avoid actual bad things. For instance — being late. I only recently worked out that if I’m late, or MIGHT be late, turning up in a self-flagellating mess does not actually buy me anti-lateness points. Anxiety really, really wants you to believe that it’s only tormenting you for your own good, and you have to collaborate with it in order to prevent disaster. Telling it “You can do what you want, but it won’t have any effect on the actual universe and so I’m not joining in” is very powerful.

I’m glad this thread is here, I was wondering if it was ever going to be. I hope the fellow whose problem prompted this is doing better.

Phospher said: July 9, 20132:58 pm

*Oops, that should be, I worked out that trying to fight off the feelings DIDN’T work.

keelyellenmarie said: July 9, 20134:04 pm

My anxiety at its worst is also very physical, and I have a friend who is the same way–we both have palpitations absurdly frequently… sometimes constantly. We both separately found out in high school that we have a mostly-benign heart defect–mitral valve prolapse–that happens to substantially increase one’s risk for palpitations and anxiety disorders, because the heart murmur itself tends to make people slightly over aware of their heartbeat. Mind you, NEITHER of us heard this anxiety-related info from the cardiologists who diagnosed the defect (to be fair, those doctors were probably just glad to be able to tell these perfectly healthy high school girls that they didn’t have major problems). It was only later, in her case when an observant therapist read her medical records carefully, and in mine when I was falling down the wikipedia rabbit hole one day, that we learned about the association with anxiety.

I haven’t personally done anything with this information other than been enormously comforted by the fact that anxiety happens to me in part because of how I am wired and it isn’t just ALL MY FAULT. My friend actually went on beta-blockers for awhile, and still will sometimes use them when she’s having a bad anxiety spike related to life events. She doesn’t like taking them any more than necessary because a) side effects and b) she wants to practice dealing with the cognitive side of her anxiety too, but she has been glad that she’s used them in the past.

Anyhow, I have no idea if you have a similar thing going on, but just for your own comfort, consider the idea that your anxiety COULD theoretically be related to something physically “wrong”… something a little mis-wired such that you are oversensitive/overresponsive to certain stimuli… without it MEANING anything about your overall health. I had an amazing primary care doc (nurse practitioner, actually) who was SO helpful with this, because she could acknowledge to me that the problem I had were partly related to some physical things that were out of my control, but also assure me that I didn’t have to worry about actually dying…that the main consequence of my miswiring is that my body is too quick to start a physical anxiety response and REALLY bad at winding one down (see upthread, I once had a week-long episode of severe palpitations/panic attacks that had to be controlled with large doses of of meds), and not anything more dangerous.

If you can establish a similar rapport with your main doc, or find a new one who is as awesome as mine, I can see that being very helpful. Just someone who could respond helpfully to “hey doc, I have palpitations like, all the time, and I am pretty sure they’re anxiety but I sometimes freak out that they’re something serious, could you just humor me and check and reassure me?” I mean, theoretically that should be ANY doctor worthy of the name, and anyone who responds badly to that should be immediately fired as your doctor, but unfortunately some insensitive assholes are out there “practicing medicine”.

Phospher said: July 10, 201312:26 pm

Thanks for the thought. Is it something that’s easily detected? If it is, I probably don’t have it — I had my first run-in with palps when I was 22 and got scared that something was wrong and had an ECG done and it was fine. My dad does have some kind of mild congenital heart defect, though, so I guess it might be possible. I certainly feel my body is wired poorly for winding down anxiety responses! But whether that’s how I was born or something I acquired or, most likely, a mixture of both, I don’t know.

After the first incident, I didn’t have any more trouble until my late 20s, when it came on so gradually that I was 31 before I realised anything was wrong. Weirdly, even when the palpitations were incapacitatingly bad I was never actually scared I was physically ill. My body might get into a state appropriate to imminent death, but I never actually . THOUGHT I was dying. How I managed to avoid understanding for so long that something was definitely wong and if it wasn’t physical it had to be mental, I don’t know, but I guess I thought it would go away by itself.

I don’t have panic attacks, exactly, I have very very high plateaus rather than spikes. I guess the feelings are less severe but the downside is they’re way more self-sustaining and can last for, you know, EVER. Anyway, I’m currently doing much better, I no longer have palpiations all the time or even that often. When they come on, meditation, exercise, or recognising and recalibrating my approach to stressors usually stops it from getting too bad. Occasionally I like to stop and marvel that something I once thought impossible is happening, my heart beating quietly and peacefully in my chest.

keelyellenmarie said: July 11, 20133:30 am

My heart defect was detected because I have a murmur, but it’s a very quiet one and you can only really hear it well when I’m laying down (unless you’re a really badass cardiologist). It wasn’t detected until I was almost 16, which freaked everyone out for a bit because a NEW murmur is a very bad thing, so they checked me super thoroughly. Turns out, I’ve had it since birth, just haven’t had doctors who listened well enough to catch such a slight murmur. Anyhow, My EKG was clean, but they did a sonogram of my heart and you can see the slightly malformed valve causing the noise. So theoretically, it is mis-able, but if you’ve had people looking into your heart and stuff, it seems unlikely that they’d miss it.

Either way, it doesn’t much matter. It could be that defect, or any number of other slight defects, or something else entirely that we don’t even KNOW makes people more palpitation-prone. As long as you’re sure you’re healthy, there isn’t much to do about it other than maybe take comfort from knowing that some people are just wired that way, and you happened to draw that particular unlucky card. And there are much worse ways to lose the genetic/developmental lottery, right?

And for what it’s worth, I’ve had panic attacks, but I’ve also done the long-plateau thing. That’s one thing I’ve been interested and pleased to learn from this thread, that lots of other people also have these sort of in-between stuck-on-anxious states that are bad enough to make functioning difficult and to be really uncomfortable, but without the full on paralyzing-ness of what is classically considered a panic attack. In general I’ve had great doctors, but the way they’ve always talked about it is more binary terms… either you’re low-level anxious or you’re having (or about to have) a full on attack, you can’t be stuck at the very-very-uncomfortable-but-can-still-pass-as-normal-with-great-effort stage for any length of time. So to try and fit my experience into that language, I tend to describe my plateau periods as long, milder panic attacks and my paralyzingly intense attacks as ‘really bad’ panic attacks. This seems to get the point across well enough to keep me in meds, so it’s functional, but after reading about the range of experiences here I feel like there should be like, a spectrum of severity, or classifications of different types of panic attacks, or something, to make the language more clear? I don’t know.

Anyhow, to use the plateau versus spikes idea, the week-long incident I mentioned earlier would probably be best described as a week-long high-anxiety, constant palpitation, plateau during which I was particularly sensitive to spikes? Something like that. Blah, now I’m just rambling.

Point is, my anxiety symptoms occur in a range from general high-stress levels to significant physical discomfort to full on I-think-I-might-die panic. They also are related to both abnormal physiology and to cognitive stuff, and the two feed on each other to the point that it’s often impossible to separate them out. Bodies are weird and complex things, and sometimes they’re kind of awful.

But I’m glad you have mostly found solutions to your issues. I keep my shit mostly in check with exercise/meditation/occasional meds as well, and you’re right… being able to have a normal heartbeat most of the time is pretty fucking awesome.

Palpitations are a huge symptom of my anxiety too. I’ve never been formally diagnosed, but for a year I lived as constantly anxious.

It was there when I woke up. It was there while I got dressed and went to school and travelled home and ate dinner and played games and just existed and when I went to sleep and when I rolled over at night. The worst times were when I was so so tired, but couldn’t sleep because of the rolling storm in my chest. And I was always tired, so tired that lifting my hand to brush some hair out of my eyes was too hard sometimes.
The palpitations were so bad that I could look down at my chest sometimes and my t-shirt would be visibly moving along with my heart. My pulse was always elevated. Every little thing was terrifying, and I used to get so angry and sad that I had to work so hard just to get out of bed while everyone else was seemingly doing these things and other Extremely Hard Things Like Study without breaking a sweat.

What seemed to make it worse was that I found out, belatedly, I was deficient in Ferretin and Vitamin D. Really deficient. Like ‘The normal score for this is about 100 and you’ve got 12’ deficient. It was great to get a diagnoses for some of it, but it didn’t help that I’d only found out because my sister had a fainting spell and tested low for D, and so the whole family was tested. My concerns were brushed aside otherwise by family and doctors alike, even though I complained of palpitations for months.

Thankfully, as long as I remain in normal levels for D and Ferretin, the palpitations are managable. I still get anxious a lot of the time and sometimes the palpitations are so strong they hurt, but it’s not a constant battle all the time, and thank *insert deity here* for that. Sometimes I look back on how bad it was and wonder how I survived with it that bad all the time. A mild anxiety attack now is unbearable, and knowing it was once that bad and worse for a year straight without a break… it makes me appreciate being anxiety free whenever I am.

Phospher said: July 13, 201312:28 pm

Oh, oh, oh, you reminded me of this song, everyone on this thread should hear this song! This is exactly what anxiety sounds and feels like.

I have a diagnosis of social anxiety, although I fought the diagnosis for a while because I don’t have a lot of the common fears that people with social anxiety tend to have, like public speaking or performing, or eating alone in public. I get most anxious around relationships and especially romantic relationships. Asking people out is so nerve-wracking that I can’t do it. I’ve never asked anyone out in person. Even when I’m in a relationship, I get really stressed about it. I’m in one now (we met online) and even though my partner is super supportive and kind about my anxiety issues, I still get stressed out and start worrying that he’s secretly mad at me and about to break up with me. It’s the second relationship I’ve been in, and in my last relationship I had a lot of anxiety around worrying whether that partner was “right” for me.

I find it helps to address the anxiety with words. With my current partner, I’ll say, “I feel anxious. Is everything ok between us?” It’s taken me a long time to be able to do this, because part of the anxiety is shame around it and trying to pretend to be more together than I really feel. I do this unconsciously a lot of the time so I don’t notice I’ve been doing it until it’s gotten bad and I realize I need to say something.

Thanks for this thread, guys, it’s been really helpful. Anxiety is hard to talk about, partly because of the shame and stigma around mental illness, and partly because part of having anxiety is that voice in my head telling me I’m unworthy and I need to hide how unworthy I am so that people will like me.

I’m trying to make the leap into seeing a therapist for my anxiety, but I just… I don’t know how. I have insurance through the (US) military, but I can’t seem to figure out who I’m supposed to call. I’ve looked on about a dozen websites and they seem to allude to a bunch of things, but I just… I feel like a failure for not being able to figure out how to do this, because Anxiety. I’m not sure if this is off-topic, but if anyone has any experience seeing a therapist or getting treatment for psych problems through Tricare Prime, I would really appreciate it.

(My anxiety manifests a lot of the time in freaking out about not knowing how to do basic things that “everyone” knows how to do. Asking for help is like admitting defeat, but I can’t keep on like this forever.)

Pterinochilus murinus said: July 10, 20137:23 am

Do you have a primary care physician? If you do, you can tell them about your anxiety, and that you’d like to be referred to a therapist covered by your insurance.

I finally saw a doctor (for the first time in way too long) a couple of weeks ago. That’s a good idea, and now I’m just trying to convince myself that it wouldn’t be super weird to go back to get a referral, which I may or may not need.

Thank you.🙂

Taking Over From Jerkbrain (or trying to) said: July 9, 20132:28 pm

I didn’t realize for YEARS how much anxiety I have/had. Because I am anxious all the time I am a control freak. Because I’m a control freak I isolate myself from everyone because I don’t measure up (keep in mind that by measuring up I mean out Martha Stewarting Martha Stewart..and then some). Because I am lonely (I think) I wind up coming up with more restrictive routines…and so on. My therapist is very helpful about giving me scripts to talk myself through the spirals and sort circuit them sometimes but my biggest obstacle is the feeling that all my scripts and so forth are “remedial” and that I should be able to do this unconsciously and not being able to do it means I am (fill in blank with nastiness). Every time I see something that has a choice of default settings I wish my brain came with one too.

I get a lot of “invitations to get together” that are indistinguishable (to me) from politeness, and invitations to gatherings that are indistinguishable to me from inviting every FB friend within gathering distance of New York (I did enjoy the meetup here, but I wasn’t able to stay long, alas). I never respond otherwise, because I don’t want to annoy people.

My girlfriend thinks I have social anxiety. I went to a therapist (months ago the Captain pointed me to very helpful advice for picking a therapist, and I used that) and he said “I don’t think there’s anything wrong with you.”

I’m not going to go back to him in any case, because I don’t think we had chemistry, but the nature of the condition is such that I don’t know how much I can trust my assessment.

Eve said: July 10, 20138:19 am

It’s not helpful for a therapist to say there’s nothing wrong with you. If you are struggling and think you need help, then seeing a therapist is likely going to be useful even if you don’t have a diagnosable condition. Obviously that therapist was not the right one for you if he is so dismissive. I’m sorry that happened to you; if it were me it would start me on a long self-doubt spiral. I spent a lot of years not getting therapy because I had convinced myself that my problems weren’t worth a therapist’s time. I can see now that what I was really doing was convincing myself that *I* wasn’t worthy of getting help. I don’t know if you’ve had thoughts like that, but you are worthy. If you feel you need help, then you have a right to seek help, and you have a right to find a therapist who is helpful to you.

mooocow said: July 9, 20133:34 pm

I had anxiety and panic attacks for years before I even realized what they were (relatedly, I also suffered from depression for years before getting diagnosed). Not understanding myself, and having a bunch of really weird and unhealthy symptoms without knowing what they were or being able to do anything about them was the worst.

Most of the time my reaction to this subconscious anxiety was fight – I would do anything I could to “get things under control”, to prove to myself that I was on top of things. But because this drive to prove myself was so strong, eventually I would end up totally overwhelmed. That usually manifested itself as some unknown physical ailment, so for a long time, I was suffering from “my mysterious illness”. In retrospect, a lot of it was generalized anxiety, or a kind of long-term panic attack that immobilized me without me knowing what was going on. I was super surprised the first time I got the connection from the physical sensations to the actual feeling. Like “Wait, this is what it’s been all along?”

Also, in relationships (particularly with my SO), small things may cause a big fear of being abandoned, but for most of my life I didn’t realize it was fear and just reacted aggressive (still do sometimes). At some point I (i.e. my feelings) “got it”, and suddenly some tiny irrelevant thing SO said or did caused me to fall into this deep black hole of despair which i can’t even begin to describe in words. Is was really bad, but once the connection was there, I could deal with it – “Oh, it’s only fear? I can deal with fear, I just need to go through it and come out on the other side.” It was horrible, bu